Accountability in Healthcare


Accountability in the healthcare domain refers to efforts by individual professional or a group of Medicare practitioners taking ownership in practice by focusing on quality healthcare provision irrespective of the location at a cost-effective manner (Forgione, Liu, Smith & Liu, 2018). It refers to every single practitioner taking into consideration the critical need for quality care and as well as expecting other related caregivers honor quality care provision. The accountability as well as cuts across professional practice, access, legal and ethical awareness, and practice, financial effectiveness, community benefit and also public health advocacy. An accountable care organization in a similar manner refers to joint efforts of medical professional and Medicare organizations to propel quality healthcare services at a cost-effective manner where the resources required in medical care provision are pooled, knowledge and expertise optimized and as such minimizing cost (Forgione et al., 2018). The community and healthcare beneficiaries typically benefit from quality coordinated and dedicated care.


Accountable Care Organizations (ACOs) are groups of doctors and several healthcare providers who pool their services to make access to quality healthcare affordable to its benefactors. However, the practitioners and doctors involved ought to benefit from the cost saved in providing their services. Contrary to the expected compensation model, the government and health advocacy authorities reward AOCs on basis of generalizing perspective of services provided (Mason & Massarweh, 2016). As such, the superiority of care provides in light of benefits transferred to the clients hit a compensation concern. Ideally, the practitioners involved would appreciate more if the compensation policy took into consideration the efficacy offered via quality a solutions offer to complex medical concerns through the efforts of the expertise of the ACOs (Pimperl, 2018). Such omission in the payment model creates loopholes in the system which leads to practitioners focusing on other platforms where such efforts expertise gets significant compensation an, in the long run, the issue could lead to collapse of ACOs in the community.

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Again, AOCs have imbalanced staff assignment and allocation among their health care provision environments. For instance, the ACOs focus on having several specialists’ representation in the health care center where patients access their medical needs (Pimperl, 2018). However, the system does not match the needs of every community and as such may lead to under or over the provision of specialists services. Where such specialists’ services are not fully utilized, i.e. the manpower resource allocated for the community exceeds the needs of the patients, such resource reduces its relevance to cost optimization. In the same perspective, under the provision of requiring specialty increases workload for the practitioners an, in the long run, could reduce the degree of quality healthcare. Collectively mismatch in staff needs and allocation in ACOs healthcare centers reduces productivity and as such loosing on the key objective of optimizing healthcare quality and cost. 

Moreover, technological incompatibility challenges the efficacy of ACOs. ACOs focus on reducing process and service redundancy as a key strategy in increasing care quality and saving on medical costs (Pimperl, 2018). Typically, implementation of a seamless ACO demands that reliable technological systems be used in sharing information for the patients across the involved practitioners have access to the patients’ information with minimal or nil omissions. As such, ACO centers need to be fitted with reliable information infrastructure which for instance is expensive in the short run and subject-specific incompatibility challenges. Incapability to provide such infrastructure contradicts ACOs objectives in reducing redundancy and correspondingly reduce cost efficiency in the provision of quality health care. Collectively, incompatibility and technological mismatches in synchronizing process flow among various specialists reduce desired effectiveness and reducing the ACOs relevance.

Furthermore, the lack of management and leadership structure pushes ACOs to the managerial struggling edge. Ideally, ACOs forms groups of specialists pooled together to provide medical services (Pimperl, 2018). A typical setup for institutions demands that management ought to take initiatives not only in setting the vision but directing the team involved towards actualizing the institution’s vision. To the contrary, ACOs tend to lack managerial and leadership structure which unfortunately sets a foundational challenge in keeping the group focused and committed towards quality care. Moreover, selected leaders to leads the ACOs lack continuous leadership training and such lack the required skills in actualizing daily managerial tasks. In the long run, the lack of efficient and trained management limits the continuity of the ACOs and correspondingly threatening provision of quality care affordable. 

Impact of Practitioners’ Roles

In the long run, the challenges affecting the ACOs have a high likelihood to affect the roles of the health care practitioners (Mason & Massarweh, 2016). The key roles include adhering to professional competency and providing quality care to patients irrespective of their social and financial positions. However, in situations where the health care providers feel inadequately compensated, they might ten to be subjective in their service providing quality and dedication. As such, limitations in the system to ensure the ACOs financial needs are addressed will trigger a change of their roles and might refocus on their roles and dedicate to other organizations where such needs are taken into consideration a collectively disorienting their professional competence values. 

Similarly, the subjection of clinical and medical practitioners to extreme workload introduces stressful experience in their work environment (Forgione et al., 2018). Ideally, the practitioners’ extreme workload relates to an imbalance in staff allocation in most of the accountable care organizations. Collectively, limitation to work and social life balance encourages the development of strategies to strike the balance and in the long run, might reduce the quality of care which as well increases the cost of healthcare provision in the community. Similarly, lack of supportive infrastructure such as tools to support the seamless flow of information disorients the overall objective of ACOs and collectively reducing its relevance. Continuity of such trends in the health care providers reduce the practitioners’ motivation and over time reduce their focus on quality practice (Pimperl, 2018). In a similar manner, lack of effective and reliable management and leadership significantly contribute towards reduced dedication. 


However, the challenges facing ACOs could be minimized by adopting reliable strategies in optimizing quality care through the use of technologically founded infrastructures and adopting managerial and leadership policies within such healthcare service centers (Forgione et al., 2018). Importantly, Medicare could base the staff allocation on needs of the centers as a strategic approach in striking balance between needs and available workforce. Adoption of objective and informed policies could assist tackle professional and political challenges affecting the roles of the ACOs.


Forgione, D. A., Liu, H., Smith, P. C., & Liu, H. H. (2018). Publication outlets for healthcare financial research: A study of journal quality perceptions. Financial Accountability & Management, 34(3), 288-305. doi:10.1111/faam.12157

Mason, M. C., & Massarweh, N. N. (2016). Accountable Care Organizations. Principles of Coding and Reimbursement for Surgeons, 115-131. doi:10.1007/978-3-319-43595-4_9

Pimperl, A. F. (2018). Re-orienting the model of care towards Accountable Care Organizations. International Journal of Integrated Care, 18(S1), 105. doi:10.5334/ijic.s1105

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