Relevant Stakeholders and Their Perspective on the ACO
Relevant Stakeholders in the ACO in managing diabetes include: The Bronx ACO Provider Group, Insurance companies (both public and private), the Patient and the Target patient population community (The Bronx), The Government (Federal, State and The Borough)
With regard to providers, their perspective on the ACO relates to their reimbursement. The payment reform affects how they get reimbursed. Post ACO reimbursement is tied to performance and extra benefits through gain-sharing as highlighted earlier. As such, they have to coordinate with all stakeholders in managing diabetes and ensure efficient patient management in order to bring about cost reduction.
The stake [what is this?] of the CMS is to ensure cost containment in managing chronic diseases for its beneficiaries. The agency hopes to maintain a healthy pool of beneficiaries through its legal contract with the ACO provider groups which in the long term will save cost.
Referral centers that refer diabetes patients to Gotham Hospital also have overarching interest in the care of these patients as their reimbursement is tied to the outcome of patient care by ACO associated structural unit.
Of vital importance is the perspective of the target patients on ACO. The ACO provisions are intended to offer quality care to these patients. However, awareness and utilization remain a major issue. Most patients are either not aware of the ACO provisions or cannot differentiate it from other model of the health organization. [Do they need to? What is the issue? Utilization]
Hence, the need for local coordinators to disseminate health related information to these patients. This is particularly important due to the challenge the Bronx community’s uninsured and underinsured population presents. [which are what? The Bronx is similar to other urban communities throughout the US]