Affordable Care organizations

Accountable Care Organizations in Rural America
Candidate’s Name
Institution’s Name
Abstract
In this study, the researcher proposes to investigate the challenges that the rural American healthcare institutions and practitioners encounter as they seek to establish and implement the Accountable Care Organizations (ACOs). Created by law to enhance healthcare quality, ACOs formation requires meeting certain legal, organizational as well as monetary conditions that have become a hindrance to the rural communities. In investigating the obstacles to the creation and implementation of the ACOs, the researcher hopes that the prevailing rural/urban healthcare inequalities shall be reduced through policy amendments. Further, the needs and unique challenges faced by the rural populace should be acknowledged within public policies recognizing the value of the rural populace. In this proposal, the researcher shall provide a brief review of the problem statement and introduction to these challenges as well as the aim of the study. Lastly, the researcher proposes study questions which will guide the research and the annotations of references that seemed germane to the proposed topic.
Keywords: Rural healthcare, challenges, Accountable Care Organizations
Topic: Challenges Facing the Establishment and Implementation of Accountable Care Organizations in Rural America
Research Statement
Accountable care organizations (ACOs) are the current trends within the healthcare sector. ACOs are a novel Medicare reimbursement and healthcare service provision substitute created under the Patient Protection and Affordable Care Act (ACA).

The ACOs produces opportunities for health caregivers to enhance the quality of treatment as well as manage treatment expenses within the community. However, even with these fresh opportunities, a better future for rural American health caregivers and patients remains uncertain. The rural care givers continue to face a myriad of challenges with the creation as well as continued implementation of the ACOs. These challenges may be attributed to low population in rural areas, legal hurdles as well as ignorance of the healthcare leaders.
Introduction to the Problem
The expression ACO was formulated in 2006 to explain a partnership of healthcare givers who are together held responsible for attaining quantifiable health quality advancements as well as decreasing the expenditure on treatment (MacKinney et al., 2013). Thus, within its center, ACOs are groups of physicians, health facilities as well as other healthcare givers who willingly create an organized association to offer high-class treatment to their clients. The overriding aim of the ACOs is to make sure that every patient obtains an appropriate treatment at the correct time minus any duplicity of roles. Consequently, ACOs are health care provision structures that are coordinated to enhance treatment quality as well as regulate treatment expenditure via a providers’ cooperation, who are then held responsible for their operations.
Despite an ACO being based in urban or rural centers, various competencies and meeting legal requirements are vital for its success. MacKinney et al. (2011) have explained these competencies, to which belong: a cooperation culture; technological infrastructure for administration as well as treatment coordination; infrastructures necessary for evaluation, reporting as well as for management of quality; the capacity to handle fiscal risk; the capacity to get as well as disburse funds; as well as the resources for clients’ support and learning. The author asserts that these competencies are very normal within big and well-established urban ACOs. However, some rural healthcare givers and facilities lack some or all of these competencies making them unqualified to form ACOs. Therefore, rural caregivers have been abandoned and have not been regarded while creating this healthcare policy thus, hindering their involvement in the ACOs.
Vaughan and Coustasse (2011) explain that there are some considerable obstacles to the rural establishment of ACOs. The authors have acknowledged a few rural limitations to ACO involvement. They argue that medical development occurs in urban structures. Consequently, the ACO notion is founded on urban encounters. However, this urban paradigm might not be realistic or practical with several autonomous rural medical facilities as well as other small hospitals. Secondly, some rural practitioners have not committed resources to create instruments needed to organize care as well as handle population health effectively. Thirdly, Medicare needs ACOs to consist of 5,000 beneficiaries that are a huge figure for several rural caregivers, and this prevents many rural healthcare providers from taking part in the ACOs program. For the urban caregivers, attaining 5,000-patient condition is easy but for their rural counterparts, achieving this condition is affected by a range of factors such as location as well as closeness to other caregivers.
Ortiz et al. (2013) in their study established that close to half of the participants stated that they have minimal knowledge on ACOs, and just 1% indicating that they are very conversant with ACOs. In terms of challenges faced, more than 50% of the participants mentioned financing as well as legal challenges as the cause of their non-involvement in ACO programs. Other respondents (41%) said that their populace base did not meet the legal threshold for qualification.
MacKinney et al. (2013) in their study acknowledged that rural health care providers encounter rare problems as well as have distinct needs from their metropolitan colleagues. They observed that ACOs’ repercussions for rural caregivers are considerable. The ACO members do not anymore depend entirely on business paradigms which prioritize service quantity rather the caregivers must focus and use resources to improve medical care quality, enhance the client experience, as well as lower care expenses. This drift requires competencies that most rural caregivers lack.
Purpose of the Study
The goal of this article is to examine the problems faced by the rural health care providers in forming and maintaining ACOs. The findings of this study shall provide an insight into the rural health care leadership to ingeniously develop healthcare provision novelties which will serve rural populace along with making sure permanent feasibility of rural healthcare givers. Further, through this research’s findings, the rural healthcare givers shall appreciate the need to overcome challenges and form networks to organize health services which enhance treatment as well as regulate expenses. These networks shall then set off reciprocally effective cooperation with other bigger healthcare organizations.
Research Questions
In exploring the research topic the research shall be guided by the following research question:
Whether the rural health care providers encounter problems with the establishment of the ACOs
What implementation challenges do the rural ACOs face?
Annotated Bibliography
MacKinney, A. C., Mueller, K. J., & McBride, T. D. (2011). The march to accountable care organizations—how will rural fare?. The Journal of Rural Health, 27(1), 131-137. https://www.researchgate.net/profile/Timothy_McBride/publication/49727633_The_march_to_accountable_care_organizations-how_will_rural_fare/links/00b495215990b0b6ff000000.pdf
The authors in this journal explain a plan for rural health givers, rural societies as well as policy makers to champion or set up ACOs in rural areas. The authors investigate ACA’s consequences, through the utilization of literature to illustrate thriving integrated healthcare institutions. They assert that past studies that investigated managed care organizations in rural areas discovered victory narratives which may be utilized to enlighten the establishment of ACOs in other rural areas.
MacKinney, A. C., Vaughn, T., Zhu, X., & Mueller, K. J. (2013). Accountable care organizations in rural America. The rural policy brief, (2013 7), 1-4.
The authors explored the geographical distribution of ACOs within the US. They discovered that ACOs function in rural counties within the US. In total, over 70 Medicare ACOs are working in urban as well as rural areas. However, of this total figure, only 16 percent of the Medicare ACOs work in rural areas. Nine of these ACOs function wholly in the countryside. These findings illustrate that there is few ACOs distribution in the countryside as contrasted to urban areas.
Ortiz, J., Bushy, A., Zhou, Y., & Zhang, H. (2013). Accountable care organizations: benefits and barriers as perceived by Rural Health Clinic management. Rural and remote health, 13(2), 2417. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761377/
The authors report the findings of a study on the obstacles and advantages of taking part in ACOs by the Rural Health Clinics (RHC). They established that ACOs are unknown to RHCs with 48 percent of the study interviewees having minimal information on ACOs. The respondents stated that the advantage of ACOs is enhanced healthcare quality. On the obstacles, the authors established that most RHCs encounter financial difficulties to advance their IT structures as well as legal and control constraints.
Vaughan, A., & Coustasse, A. (2011). Accountable Care Organization Musical Chairs: Will There Be a Seat Remaining for the Small Group or Solo Project?. Hospital Topics, 89(4), 92-97. http://mds.marshall.edu/cgi/viewcontent.cgi?article=1042&context=mgmt_faculty
This publication investigated the possibility of small groups (that characterize rural population) as well as alone practitioners’ involvement in ACOs. They authors assessed five cases that indicated that these categories of players face considerable organizational, monetary as well as technological problems which they must overcome so as to establish ACOs. The authors noted that adequate resources to overcome these obstacles were best provided by big healthcare establishments that are found in urban areas.
References
MacKinney, A. C., Mueller, K. J., & McBride, T. D. (2011). The march to accountable care organizations—how will rural fare?. The Journal of Rural Health, 27(1), 131-137. https://www.researchgate.net/profile/Timothy_McBride/publication/49727633_The_march_to_accountable_care_organizations-how_will_rural_fare/links/00b495215990b0b6ff000000.pdf
MacKinney, A. C., Vaughn, T., Zhu, X., & Mueller, K. J. (2013). Accountable care organizations in rural America. Rural policy brief, (2013 7), 1-4.
Ortiz, J., Bushy, A., Zhou, Y., & Zhang, H. (2013). Accountable care organizations: benefits and barriers as perceived by Rural Health Clinic management. Rural and remote health, 13(2), 2417. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761377/
Vaughan, A., & Coustasse, A. (2011). Accountable Care Organization Musical Chairs: Will There Be a Seat Remaining for the Small Group or Solo Project?. Hospital topics, 89(4), 92-97. http://mds.marshall.edu/cgi/viewcontent.cgi?article=1042&context=mgmt_faculty