Tag Archives: Accountable Care Organisations

Government policy on Accountable Care Organisations remains confused and confusing. The Health Select Committee’s recent grilling of Simon Stevens and Stephen Barclay shed little light on critics’ concerns, while the relative responsibilities of the Accountable Care Organisation and its commissioners remain murky, and subject to legal proceedings. What is clear, however, is that Accountable Care Organisations will be responsible for deciding most of the issues that really matter to the public in the provision of health and care services. This will be even more the case if commissioning is on the basis of long term health outcomes. It will be […]
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Instead of Accountable Care Organisations The NHS in England is being reorganised, yet again. Jeremy Hunt and his advisors have decided to turn upside down their own previous reforms. Now commissioning organisations (CCGs) and service providers (NHS Trusts) will be brought together into large Accountable Care Organisations (ACOs). How this will work in practice is not clear and rightly there have been calls in Parliament to scrutinise the changes. A coalition of health campaigners, including Stephen Hawking, are also trying to take the Government to court to stop these plans. In one minimal respect these changes are positive, for they […]
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The decision to accelerate the development of Accountable Care Organisations (ACOs) in England is unwise, unnecessary and should be challenged.  It is hoped the SHA will support the Judicial Review and the Early Day Motion from Labour. Sadly ploughing ahead with the contracting model for ACOs without any proper explanation, consultation or engagement is typical of what the NHS has been doing, with the secrecy around Sustainability and Transformation Plans as a textbook example of how not to do things.  You cannot make changes on this scale without taking staff patients and public with you – and you should not […]
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Now the Labour Party’s objectives for the NHS are clearer, the real politics begins. If May’s government collapses, as looks increasingly possible, Labour will need to project its tactical policies for the NHS forcefully. The plausibility of how it plans to cope with the winter bed crisis will matter – what will the £500 million promised be spent on? How will a Labour Secretary of State for Health manage delayed transfers of care? If May’s government survives Labour will have to live with Hunt Supremacy for a while longer, and will need some practical ideas. Two events in the last […]
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The latest great reform for the NHS is now unveiled – the creation of Accountable Care Organisations. This sounds great doesn’t it? bring commissioners and providers together end contracting and the internal market focus on community and service integration improve efficiency with better data and innovation Advertisement – ADVERTISEMENT – I am not quite sure how this sounds to anyone outside the NHS. It may sound like a set of good ideas or just empty jargon. To those inside the NHS it promises yet another round of meaningless organisational change, personal confusion, management consultants, promotions for some and redundancies for others. […]
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Written for the membership of the National Pensioners Convention Health and Care autumn Newsletter, so for potentially a relatively non expert audience (but quite a few are real experts and very engaged and passionate).  It refers to an Americanised system – the current direction of travel under the government. Accountable Care Organisations (ACOs) are surprisingly upfront about their aims, ambitions and raisons d’etre. The US frontrunner amongst ACO’s, Kaiser Permanente, emphasises the importance of bonuses, asserting that providers will make more money if they keep patients healthy. That might look reasonable until we think a bit more deeply about what it […]
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The Next Step To Privatisation? They Aren’t Accountable, They Don’t Seem To Offer Better Care And They Are Not Really Organisations. The biggest ever NHS tender for £6bn over 10 years was launched recently for a Local Care Organisation – a single provider for all “out of hospital” health and care services for 600,000 people in Manchester. The contract will be let by a partnership between the council and a new single Clinical Commissioning Group. This is the latest variant of an ACO – we shall be seeing more of them over the next few years. What are Accountable Care […]
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“Accountable Care Organisations” are mentioned 18 times in the Cheshire & Merseyside Sustainability and  Transformation Plan with no details or background. Massive reorganisation plans are now surfacing in Warrington, St Helens, and West Cheshire. Management consultants PwC, who helped write the STP itself, are guiding developments. Accountable Care is a concept from the US health insurance market. The idea there is that a group of healthcare firms take responsibility for providing care for a given population for a defined period under a contract with a commissioner, such as Medicare. ACOs use market-based mechanisms to lower costs whilst achieving pre-agreed quality […]
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The principle changes in the Patient Protection and Affordable Care Act, signed into law on 23rd March 2010, mean that it is mandatory for people to buy healthcare insurance (or face fines), and encourages insurers to insure people who are deemed as high-risk, and would have previously been denied coverage. The PPACA takes a step in the right direction for US healthcare in terms of reducing the number of people who are uninsured. One of the most notable aspects of the Act is the creation of health insurance exchanges, which will provide federal assistance for those who are not covered by […]
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It has become de rigueur on the left to regard the US healthcare system as the very incarnation of evil and therefore a country from which nothing of value can be learned for improving our NHS.  This might be about to change. There is now growing interest in the notion of the ‘Accountable Care Organisation’ (ACO) – or as it is tending to be termed over here, the Accountable Integrated Care System. The Accountable Care Organisation concept is gathering pace in the US following the 2010 Patient Protection and Affordable Care Act, which included a pilot programme to explore ACO structures […]
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