Ethical Practice Under Accountable Care

Abraham D Graber; Asha Bhandary; Matthew Rizzo

doi:10.1007/s10730-015-9280-x

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Journal article

Peer reviewed

Ethical Practice Under Accountable Care

Abraham D Graber, Asha Bhandary and Matthew Rizzo

HEC forum, Vol.28(2), pp.115-128

06/2016

DOI: 10.1007/s10730-015-9280-x

PMCID: PMC5501323

PMID: 26002491

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Abstract

Accountable Care Organizations (ACOs) are a key mechanism of the Patient Protection and Affordable Care Act (PPACA). ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice (no novel conflicts with non-maleficence were identified). Conflicts include a bias against transient populations, a motive to undertreat conditions lacking performance measures, and the mandate to improve population health incentivizing life intrusions. After introducing and explaining each conflict, recommendations are offered for how providers ought to precede in the face of novel ethical choices. Our description of novel ethical choices will help providers know what to expect and our recommendations can guide providers in choosing well.

United States

Beneficence

Patient Protection and Affordable Care Act - economics

Patient Protection and Affordable Care Act - ethics

Humans

Accountable Care Organizations

Details

Title: Subtitle: Ethical Practice Under Accountable Care
Creators: Abraham D Graber - Philosophy & Religious Studies, Western Illinois University, 456 Morgan, Macomb, IL, 61455, USA. agraber@gmail.com
Asha Bhandary - University of Iowa, 258 English-Philosophy Building, Iowa, IA, 52240, USA
Matthew Rizzo - Department of Neurological Sciences, University of Nebraska Medical Center, 988440, Omaha, NE, 68198 8440, USA
Resource Type: Journal article
Publication Details: HEC forum, Vol.28(2), pp.115-128
DOI: 10.1007/s10730-015-9280-x
PMID: 26002491
PMCID: PMC5501323
NLM abbreviation: HEC Forum
ISSN: 0956-2737
eISSN: 1572-8498
Publisher: Netherlands
Grant note: U54 GM115458 / NIGMS NIH HHS
Language: English
Date published: 06/2016
Academic Unit: Neurology; Philosophy
Record Identifier: 9984002466202771

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