What are an Accountable Care Organization and How Can it Promote Health Equity?

Health is a condition of mental, physical, and social well-being where illness and infirmity are either absent or replaced with optimal health. It is a concept that is the result of our human biology and is necessary to our survival as a species. The definition of health is the state of a person, where all the major systems of the body function at their optimum level. This means that health is the absence of any diseases, a healthy weight, strong immunity against diseases, and an ability to cope with the demands of life comfortably and without major difficulty.


What exactly does this translate into in terms of a definition of health for an individual? Well, for the sake of definition, let us use the definition from the American Psychological Association: “Mental health is the combination of healthy emotional well-being and good mental functioning.” This definition is used to stress the fact that mental health is a state, and not a thing. In other words, you are what you eat and how you feel about yourself.


In order to get a clearer picture of what this third definition means, let us examine the definitions of sickness and health. Sickness, by medical standards, is any physical discomforts brought about by an acute infection, a deficiency in some vital nutrient, or a serious bodily injury. We could also speak of fevers, depression, or emotional disturbance. On the other hand, we could also speak of an illness when the normal functions of the body or the normal operations of the body in its normal range are affected. When these conditions persist for more than a few days, they could be classified as ill.


What we are trying to ascertain by considering the first two definitions, illness and health, is what is missing in the current health care system. The illness is often associated with terminal conditions that are life-threatening; a lack of health care may cause loss of a limb, or even your eyesight. However, this third definition underlines the notion that the health care delivery system itself is deficient, and what is needed is a better definition of what an accountable care organization is as well as what its processes must include.


In this respect, what is needed is a health equity perspective. What do the health care outcomes in the United States look like for people who live in different states, for whom different health problems occur, for whom different health conditions occur? What does the health system look like for children with different parents, for women who experience pregnancy at different times, for people with different race and ethnicity? For all of these cases, a true Health System Reformation is needed. And one way to achieve that is to make sure that the definition of what an accountable care organization looks like includes everyone who will be beneficiaries of the new health care reform law.


In order to reach this goal, we must move from a single-payer system to health systems that look more like a social network or a public utility. For example, there is a great deal of effort now to connect health systems within universities, hospitals, and other medical institutions. Some of these attempts have been successful, but most have been less than effective. Health management information systems need to provide physicians across the country real-time access to up-to-date and comprehensive data about how-well patients are communicating with their primary care physicians. Such systems also need to provide doctors and other staff members with easy and reliable ways to gather and evaluate real-time data about the health of patients who are part of the health systems that are part of these networks.