Evaluate standards of care and potential liability for health care professionals and organizations. There are many ways in which ACOs and affiliated providers may face increased risk of liability for their actions. The first is an increase in liability for new duties imposed by certain documentary requirements of the Act.
For example, the Act requires each ACO to demonstrate “that it meets patient-centeredness criteria specified by the Secretary [of HHS]. such as the use of patient and caregiver assessments or the use of individualized care plans.” The HHS regulations further require each ACO to “provide documentation in its application describing its plans to.
- Promote evidence-based medicine.
- promote beneficiary engagement
- report internally on quality and cost metrics
- coordinate care.
Institutional Liability for Accountable Care Organizations
ACOs may not only face increased liability stemming from record-keeping requirements in the PPACA, but also from the nature of the services they render. According to the Act, “[t]he ACO shall be willing to become accountable for the quality, cost, and overall care of the Medicare fee-forservice beneficiaries assigned to it.”
This language in the Act suggests that a significant shift may be underway in how vicarious and direct liability will be determined for healthcare organizations with respect to the providers caring for patients under their auspices. Traditionally, liability has stemmed from control over patient care. In the hospital setting, this has generally meant that hospitals themselves were not liable for medical negligence when it was caused by a private physician attending to his or her own patient in the hospital’s bed, or when members of the hospital’s professional staff followed the orders of a private attending physician.
Imagine you have been working for a health care organization for an extended period of time. It is clear that you have a wealth of information about the accountability and liability that individuals and organizations should be aware of. You have been asked to present to new employees to inform them of the importance of being an accountable individual in a health care organization.