Hey ACOs, what can you do for me?

August 20, 2012 in health care costs, Medical Care

I keep hearing that one day soon we’ll all be members of an Accountable Care Organization (ACO). These are big or biggish health care groups that include doctors, hospitals, labs, rehab and other things I need. The deal, as I understand it, is that I get everybody coordinating my care “under one roof”, but I’m not supposed to go outside that roof for care. I know, some ACOs let patients continue to have unlimited choice, but that doesn’t seem to be the model.

If I’m going to give up the option of going wherever I want, then what I get under that one roof better look pretty good. So, you ACOs out there, that are getting ready to sell me on your services, here’s what I’m looking for:

1) A primary care doc who responds pretty quickly to my calls, emails, texts or Skype (or has a fabulous nurse practitioner or physician’s assistant who gets right back to me). Someone who routinely asks how I’m feeling, not just whether my body is OK. Someone who makes eye contact and can explain what’s going on with words I understand.

2) A dentist who does the same (and who shares records with my doc.)

3) Evening and weekend office and lab hours.

4) An electronic medical record I can view at home and add to as needed. The record will show the prices of the tests or treatments my doctor recommends and the ones I receive.

5) A patient coach who will help me get a second opinion or find more information about my illness, set health improvement goals, and understand the costs of my care. Someone who will help me be an informed advocate for myself and my family.

6) An ombudsman with whom I can register problems or a complaint.

7) A great, easy-to-navigate website that includes my records and all the information my patient coach wants me to see: FAQs and videos or health explainer-type games as well as a place to chat online with patients who’ve been in a similar circumstance.

8) Cool incentives and rewards for staying healthy, exercising more, losing weight or quitting a bad habit.

10) Easy parking or valet service or a shuttle from the closest train station or golf carts that drop me at the front door (can we make going to the doctor more fun?)

11) Really nice front office staff who know my name and remember something about me and offer to help with the next step in my care and maybe even get me water or tea as I wait.

12) Basic tests in the same building as my primary care doc that don’t require more than a 30-minute wait.

13) Quality measures I can understand and evidence of improvement

Wish List:

1) One of those “10-minute massage” options in the waiting room (or just off to the side).

2) A next-day follow-up call to ask how my child is feeling and whether I have any on-going concerns.

3) A follow-up email with articles I might want to read, FAQs, an informational video and maybe even some medical trivia.

4)The option of making/changing appointments online.

5) Johnnie’s that make me feel good, not like a schlump. Maybe johnnie costumes for my kids and for adults?

6) Free nutrition, exercise or relaxation counseling.

7) Acupuncture in the same building.

8) A “patient’s share” of the money my ACO saves if we all do our best to stay healthy.

9) Transparent records – show me what you’re getting paid and how you are managing my health care dollars.

10) Free apps that help me stay healthy, spend less and laugh more.

Okay, what did I forget?

It may be a little early to sit back and wait for the sales calls (although hospitals are already pitching seniors on Medicare). But if the calls or letters do come, I’ll be ready to ship the reps my list and see who wins.

9 responses to Hey ACOs, what can you do for me?

  1. Martha,
    You will get your wish list when you control your health care dollar instead of your employer. Till then, your employer will be issuing the wish list for you to an insurer that will in turn try to find something that looks attractive in an ACO. Good luck!

  2. Martha, Nice list. I hope some people will pay attention.

    Parenthetically, *my* employer has not asked me if I want to control my health care costs. I suppose co-pays are included to promote our economical use of health care. Since I am sometimes a cynic, I suspect that the ACOs are more interested in something attractive to employers than something attractive to patients. Recalling the old metaphor, the ‘squeaky wheel gets the grease’, maybe we should all squeak loudly. :-)

  3. Martha, I could’ve used your help last week. I was part of a focus group on health care benefits. My employer hired a small marketing research company to get feedback on staff’s opinions on health care. In 2012, my employer created a tiered network plan, so you pay less if you use primary care docs(PCP) from one specific hospital or I look at it I pay a lot more to use my doctor that is all of a sudden “out of network”. One of the main things we discussed was what would it take for us to consider switching PCPs to this one hospital. Many of the things on your list came up!

    • Anne – fascinating – so is your employer staying with the tiered plan next year, or do you know yet? Do you know why your doc is in a more expensive tier?

      • Martha-I don’t know yet if my employer is staying with the tiered plan next year, but I think it will. I don’t know why my doc is in the more expensive tier–my employer is affiliated with the preferred tier. I did find out from the health plan’s customer service (after a bit of pestering) that the “lower-cost” tier has a alternative quality contract.

  4. If it comes down to my employer, there would be no frills. It would be more about saving money than saving my health. What you describe is healthcare nirvana, massages in the waiting room! I don’t see this in any realistic future.

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