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Accountability Care Organizations Impact on Healthcare

Paper Type: Free Essay Subject: Health And Social Care
Wordcount: 1890 words Published: 14th Jul 2021

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The role of hospitals, care delivery system in healthcare, the government impact is crucial. Meanwhile, if external pressures and modifications can potentially cause evolving concerns. Accountable care and the Accountable Care Organizations can be varied, and other hands there are many challenges and facilitating factors will be incentives to ensure quality care.

Part in accountability

Accountability is the foundation of nursing professional practice. Professional nursing accountability, that taking responsibility, judgments, and actions. Nursing accountability upholding quality care and outcomes. Professional accountability can be that applies to anyone who directly involved in professional healthcare systems such as nurses, physicians PT, OT, and ST. Accountability is taking responsibility for your actions, that ensuring you are competent to perform the practice that assigns to you. All patient cares are dedicated to nurses because nurses are the direct care provider, and spending their most of the time with the patient and their family, not only providing care, educating, researching and collaborating care with other disciplinary, such as PT, OT, ST, social worker, and Physician.

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Therefore nurses provide care coordination and patient center care as a code of professional nursing standard of practice (Nickitas & Middaugh, 2018).  Nurses are accountable for providing quality care and accomplish organization target goal. All professional nurses must take maximum accountability to fulfill organization mission by working under the scope of practice. Nurses are accountable to provide an opportunity to contribute to the improved quality of care and patient satisfaction.  Nurses play a greater role in improving patient experiences and satisfaction. However, profession nurses can help reduce unnecessary and costly hospital readmissions and preventable medical errors, providing more affordable, more convenient, and more patient-centered primary care in community-based or hospital settings.

Accountability Care Organization

Simply definition of accountable care organization (ACO) is a group of healthcare providers, suppliers, hospitals that provide coordinated high-quality care, that result can improve patient care, outcome and reduce health care cost. Medicare is the most financial model at this time and provides high incentives for providing high-quality care and reducing cost. In addition, our healthcare sectors coordinated care and communication can assist to ensure patients, who are very much chronically sick, receiving efficient care in a timely manner, without occurring any medical errors as well as avoiding unnecessary services. Using electronic health record systems that help to share medical information and data that can reduce redundancy and reduce cost, that way ACO able to achieve designated goals.

In fact when an accountable care organization (ACO) succeeds in both providing high-quality care and spending health care cost more wisely, and obviously, it will share in the savings and achieving more for the Medicare program (CMS.gov). An ACO, directly and indirectly, hears from professional healthcare workforce and making all care possible. ACO model is established in 1967 to provide care for the pediatric patient but now that organized care to spread to an extensive range of practice such as clinical specialties, chronic disease management, and families (Nikitas & Middaugh, 2018).

There are five types of ACO; all ACO facilitates care coordination, clinical practice improvement, and financial support.

  1. Integrated delivery system: for example Kaiser Permanente who own the hospitals, sponsor many health plans, specialist practice and covering an extensive range of the community.
  2. Multispecialty group practice: In this ACO is an affiliation with many hospitals and contact with different health plans. In this practice, physicians are leading care, including mayo clinics, Cleveland clinic etc.
  3. Physician-hospital organization: In this ACO subset of a hospital employee, bargaining with the health plans, and provides cost-effective care to the public. Including advocate health system.
  4. Independent practice association: For these types of ACO physicians are practicing individually, they are contracted with different health plans, care coordinate and share personal health information across are varies. For example hill physician group, my care providers are also under hill physician, they are great.
  5. Virtual physician organization: In this group physician are also an independent and small group, they serve in a rural area which is medicated agency including community care of North Carolina, grand junction Colorado etc.

Mainly ACO leverages a wide range of organization and integrated delivering care, promote population health, quality and better outcomes with controlling cost (Nikitas & Middaugh, 2018).

Challenges we face

Nurses are the largest workforce in the health care delivery system and they play an integral role in the healthcare, they are directly providing care coordination and patient center care as a core professional nursing standard of practice. Nurses are filling leadership role researcher, coordinator, educator, teacher and managers roles at healthcare organizations. The nursing profession is a demanding profession that requires a lot of compassion, dedication, and commitment as well. Nurses care coordinators roles, quality improvement, cost control measure expands across the continuum of the organization,  (Nickitas & Middaugh, 2018). There are many challenges nurses have to face while working an ACO. Including compensation, it is a big gap between region, location even gender. Workplace violence in another challenge that nurses facing today by the patient, family members, and coworkers, policy maker or employer has to look over those issues to overcome. Another challenge is that short staffing. Short staffing is a huge challenge in the nursing workforce often professional and personal ways. In fact, short staffing is the top reasons that nurses leave their job. Long working hours.  Due to many reason nurses has to work prolog hours result of risking fatigue, loss of sleep that could cause in medical mistakes, burnout and dissatisfaction patient and family. In addition, nurses who work the long shift, they intend to leave the job and express job dissatisfaction. May lead to affect patient safety and patient actual outcome differ from the desired outcome.

Another major challenge is that workplace hazards. We are facing a number of workplace hazards everyday day while performing our jobs without intention. Including exposure to blood borne, pathogens, urine and feces, injuries, hand washing-related dermatitis, a cold and flu germs, not only that we expose to many communicable diseases such as TB, Ebola, HIV aids etc.

I am experiencing hand washing related dermatitis eczema in my hand If I am working continuously few days when I expose to hand sanitizer and gloves and frequent hand washing my eczema gets worse when I am off couple days it completely disappears. Moreover, there are barriers of independent NP practice in some state physician has to oversight. Some state NP can limit authority to perform diagnosis, treatment; they can perform only under physician supervision. These scopes of practice restriction regulations will make them hard to practice and bill to payers. Therefore this barrier should be removed and NP should be practice independently and in full extent of their completion of education and training (Nikitas & Middaugh, 2018). Ultimately RN and NP both facing challenges in many ways.

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Changing role as a result of these challenges

Obviously facing many challenges healthcare workers role or performances will change, If you work a long hour or shortage of nurses, workplace violence happens you are definitely physically, mentally, emotionally tired, fatigue and unable to provide excellent care to the patient. Therefor inadequate staffing and higher use of less-skilled workers, heavy workloads,  lack of sufficient support staff; and inadequacy of wages can result from medical errors, medication errors, compensate with patient safety, poor hand hygiene, fall, hospital-acquired infection and develop pressure ulcer due to insufficient care. Poor quality care and dissatisfaction among patients and healthcare professionals. They expressed frustration and inability to participate in critical thinking decision making, poor nursing judgment, and some end up leaving the jobs. Team communication, Coordination, and collaboration of care is key to achieve good patient outcomes and can be able to lower healthcare cost.

In fact, facing those challenges can impact all of our health care quality and cost.  According to NCBI articles that I read  IOM report clearly says that the inability to apply knowledge about human factors in systems design and the failure to incorporate well-acknowledged safety principles into health care including standardizing and simplifying equipment, supplies, and processes are key contributors to a high number of medical errors performs. (Institute of Medicine, 2000). Lastly in order to provide holistic care to our patient healthcare organization, policymaker leaders, and managers has to work hard and overcome challenge across the system and uplift nursing profession.


Professional nurses are accountable for their action. Nursing accountability is upholding the quality of care and outcomes. ACO is a group of healthcare providers, suppliers, hospitals that provide coordinated high-quality care and reduce health care cost. Medicare is the most financial model and provides a high wide range of incentives. There are five types of ACO, and they facilitate care coordination, clinical practice improvement, and financial support. When providing care nurses faces many challenges such as workplaces violence, shortages of nursing, prolog hours of work etc. that challenges car cause medical errors, insufficient care to the patient, poor outcome and increase health care cost.


  • Accountability: A concept worth revisiting. (2014, September 16). Retrieved from https://www.americannursetoday.com/accountability-a-concept-worth-revisiting/
  • Accountable Care Organizations (ACOs): General Information. (n.d.). Retrieved from https://innovation.cms.gov/initiatives/aco/
  • Gooch, K. (n.d.). 5 of the biggest issues nurses face today. Retrieved from https://www.beckershospitalreview.com/human-capital-and-risk/5-of-the-biggest-issues-nurses-face-today.html
  • Institute of Medicine (US) Committee on the Health Professions Education Summit. (1970, January 01). Challenges Facing the Health System and Implications for Educational Reform. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK221522/
  • Nickitas, D. M., Middaugh, D. J., & Feeg, V. D. (2020). Policy and politics for nurses and other health professionals: Advocacy and action. Burlington, MA: Jones & Bartlett Learning.


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