Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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An Evaluation of Accountable Care Organization in USA and Policy Implications for Korean Health Care System

미국의 책임의료조직(Accountable Care Organization) 운영현황 분석과 국내 의료정책에서 정책적 함의 평가

  • Seo, Kyung Hwa (Research Institute for Healthcare Policy, Korean Medical Association) ;
  • Jung, Yu Min (Department of Medical Science, Ewha Womans University The Graduate School) ;
  • Kim, Min Ji (Department of Medical Science, Ewha Womans University The Graduate School) ;
  • Lee, Sun Hee (Department of Preventive Medicine, Ewha Womans University School of Medicine)
  • 서경화 (대한의사협회 의료정책연구소) ;
  • 정유민 (이화여자대학교 대학원 의과학과) ;
  • 김민지 (이화여자대학교 대학원 의과학과) ;
  • 이선희 (이화여자대학교 의과대학.의학전문대학원 예방의학교실)
  • Received : 2014.11.21
  • Accepted : 2014.12.22
  • Published : 2014.12.31
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Abstract

Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.

Keywords

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