Welcome to the Blog of the Duke Center for Research on Prospective Health Care

The mission of the Duke Center for Research on Prospective Health Care is to support the development and implementation of prospective health care, a personalized, predictive, preventive and participatory approach to care that is based on the integration of three key elements: (1) personalized health planning, (2) coordination of care, and (3) rational reimbursement. On this blog we discuss current issues in prospective health care and personalized medicine, including ongoing research and outreach in the Center, the work of other leaders in the field, and innovations in science and technology that can promote this model of care. We invite you to this important conversation and look forward to your thoughtful comments and ideas.

The views, opinions and positions expressed by the authors and those providing comments on these blogs are theirs alone, and do not necessarily reflect the views, opinions or positions of Duke's Center for Research on Personalized Health Care.

Friday, January 28, 2011

Health Affairs Special Issue on ACOs

This month’s issue of the health care journal Health Affairs was a special issue dedicated to the discussion of Accountable Care Organizations, also known as ACOs. The issue describes a number of exciting changes in approaches to health care being explored using ACOs. ACOs are organizations that provide care for a defined population. Under the new health care legislation pilot ACOs must provide universal care for a population of no less than 5,000 Medicare beneficiaries. The idea is akin to a large scale version of capitation. Instead of getting paid a set rate per patient, an organization gets paid for performing capitated care in bulk, providing all the health care needs for an entire community. The benefit of such a structure is that it creates the potential for novel, community-based interventions to save costs.
ACOs provide an exciting, rational reimbursement structure that would provide powerful incentives for decreasing costs through better care. If all patients within an ACO had electronic, perspective health care medical records, the community could potentially track not only health care needs of individuals, but could also identify health care needs of an entire community. For examples if a large number of patients were finding it difficult to find the time to exercise at work or were decreasing in cognitive decline due to a lack of social interaction, the ACO could use this information to intelligently guide community innovation that would benefit individuals on a large scale and result in further cost savings, improved health, and perhaps even quality of how the elderly live their lives.

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