Medicine Grand Rounds, Darren DeWalt “Healthcare Payment and Changing Healthcare Delivery: What is an Accountable Care Organization?”

As of the beginning of this year, UNC Senior Alliance, our Accountable Care Organization (ACO), is responsible for the total cost of care for approximately 24,000 attributed Medicare beneficiaries in the Triangle and Caldwell service areas, regardless of where they receive care.

Our ACO rewards coordinated care across settings and provides us with flexibility to test innovative care delivery approaches, such as telehealth in a patient’s home and expansion of home health services. By reducing avoidable costs, we can invest in other needed services (e.g., transportation services, case management, etc.).

Our first goal is to reduce avoidable ED utilization, admissions and readmissions. We are concentrating our implementation efforts on UNC REX, UNC Hospitals, Caldwell Memorial Hospital and Chatham Hospital.

Dr. DeWalt was part of the work team that implemented these programs. He is Chief of the Division of General Medicine and Clinical Epidemiology.