United States

Reforming and restructuring the health care delivery system

Are Accountable Care Organizations and bundling the solution?


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For the most part, today’s health care delivery system is considered to be fragmented and inefficient. Many experts view fee-for-service medicine as something that needs to change and change soon, especially if government intends to rein in continuing and exploding costs. The search is underway to improve and change the system. The issue is how.

Our current health care system is predicated on what worked 50 years ago and on how we paid providers then. Congress and the president, through the Affordable Care Act (ACA), have potentially expanded health care insurance for an additional 30 million individuals who currently lack such coverage. However, the federal government cannot and will not directly dictate the workings of our health care system. Telling health care professionals to or for whom they must work, and how much they can earn, is simply unacceptable.

The ACA, in addition to expanding health care benefits, continues to make traditional reimbursement reductions to provider payments but does little to make fundamental system reform. However, the ACA has set in place two interesting concepts that could make fundamental system reform—Accountable Care Organizations (ACOs) and bundling.


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