Academic journal article Journal of Healthcare Management

Practitioner Application

Academic journal article Journal of Healthcare Management

Practitioner Application

Article excerpt

Given our changing healthcare system, Westling et al. chose a timely topic for investigation. The number of accountable care organizations (ACOs) is increasing each year, and at least one organization identified more than 800 ACOs in the United States as of January 2016 (Muhlestein & McClellan, 2016). At WellStar Health System in Atlanta, Georgia, our ACO continues to grow, with nearly 42,000 patients enrolled and more than 1,250 providers participating. We see the growth of our ACO and others, in conjunction with this investigation of ethical issues, as the perfect time to evaluate ethics program structures and functions.

WellStar recognizes the need for a systematic and integrated approach to ethics. In 2015, we revamped our ethics program structure, modeling the approach recommended by the Catholic Health Association of the United States and Ascension Health (2014). This model focuses on identifying the type and range of ethics services that support organizational identity and integrity including, but not limited to, ethics consultation, ethics education, ethics policy development and review, community outreach, ethical leadership, ethics research, and integration.

These services are essential to developing and enhancing ACOs (DeCamp et al., 2014). For example, the study points to the need for both ethics program resources and the education of ACO providers. Our experience with ethics programs is that they often lack an understanding of the payment structures in healthcare and the ethical tensions created (e.g., the "incompatible reimbursement models" reported by the Pioneer ACO interviewees in the study). WellStar has tackled this problem by educating our ethics program participants (i.e., ethics committee members and ethics consultants) about the intricacies of the ACO payment model and how ACOs can create ethical tensions for providers, patients, and the system. In addition, we educate physician leaders about ethical tensions and dilemmas faced by clinical healthcare leaders. …

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