NASW Comments on ACOs: Professional Social Workers Essential to Patient-Centered, Coordinated Health Care

The 2010 Affordable Care Act created a new category of health care provider – the accountable care organization (ACO).  ACOs represent a paradigm shift from traditional fee-for-service health care.  These organizations will receive financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs.  The emergence of ACOs reflects the health care industry’s shift toward care coordination, with the locus of care centered within a primary care medical home.  If it proves successful, the Medicare ACO model is likely to be replicated broadly.

As the only health care professionals devoted exclusively to addressing the psychosocial needs of Medicare beneficiaries, social workers are essential members of ACOs.  Yet, the proposed rule for ACOs does not reference the social work role in caring for Medicare beneficiaries.

The Centers for Medicare & Medicaid Services (CMS) recently requested public comment on how ACOs should operate.  NASW argued persuasively for the inclusion of professional social workers in these new provider organizations – and for strong protections for Medicare beneficiaries.  Read NASW’s comments.

As health care relies increasingly on evidence-based practice, the social work profession needs research to demonstrate its value to interdisciplinary health care teams.  Are you involved in or aware of a program for which such research is available?

2 comments

  1. Although this sounds like a great idea I have a couple of concerns about how this idea of ACOs will work. First, I am concerned that this plan does not involve hiring professional social work staff to perform the care coordination between providers. One can only imagine the dynamic of communication between hospitals, clinics, counseling centers, and long term care facilities. Who is going to be placing calls and writing up referrals, gathering client info, and conducting assessments? The Doctors, Nurses, CNAs, Psychologists, Counselors, Therapists, Directors, Assistants, Family members? My concern is the communication or lack thereof, between each of the providers involved with any given client. It would be in their best interest to include social workers as a means of quality care coordination. That way, only one individual is performing duties on behalf of clients. Social Workers would then act as the liaison and would be in charge of communicating with each of the providers to assure that everyone involved is on the same page regarding patient’s care. Second, I am concerned about the ACOs having to pay Medicare back for failing to provide efficient, cost-effective care. At a glance it only seems fair to get a refund on something that didn’t work; however not knowing the implications of this is discouraging. If an ACO is required to pay money back, where will it come from?

    On the upside though, ACOs would not only benefit the clients and the quality of care received but would also provide job opportunity for the professional social workers hired to do the care coordination. However, it sounds like we need to advocate in order to reach the intended goal. Being that ACOs do not intend to hire social workers we need to show or prove Centers for Medicare & Medicaid Services the necessity of having social workers as part of the team.

  2. Thanks Ms. Clark for submitting comments to CMS,et al re ACO’s. I agree it’s imperative we have a seat at the table! I am interested in serving on any committee NASW may have re ACO’s. I am the Past President, NY Chapter. I am also a surveyor for the Nat’l Committee for Quality Assurance (NCQA) which as you may know is about to release accreditation standards for ACO’s.I also swerve on Gov. Cuomo’s (NY)Public Health & Health Planning COmmittee. I can be reached at the email above or 716-308-6328 for follow up

    Thanks for your consideration

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