Accountable Care Organization, Healthcare Big Data, Healthcare Portal, and ACO Implementation Resources Accountable Care Organization, Healthcare Big Data, Healthcare Portal, and ACO Implementation Resources

FEATURED ARTICLES: ACO

  • The Buzzword For HIMSS11 — ACOs
    2/25/2011
    This year’s HIMSS Conference and Exhibition, held February 21-23 at the Orange County Convention Center, had a lot of things going for it. It was held in a warm weather location (Orlando, FL). It boasted a lineup of influential keynote speakers (e.g. Robert Reich, Kathleen Sebelius, Dr. David Blumenthal, and Michael J. Fox).
  • 6 Wisconsin Healthcare Systems Announce Move Towards ACO
    8/12/2014

    The partnership was developed to build upon and advance the clinical quality, efficiency and customer experience attributes that are well-documented and shared among the six organizations. By Christine Kern, contributing writer

  • Obamacare Signups Pass 11 Million Mark
    2/18/2015

    In a video posted on Facebook, the White House announced that 11.4 million individuals had either signed up or re-enrolled for healthcare via the exchanges. But that number was accompanied by a number of caveats. “The Affordable Care Act is working,” President Obama stated in the video. “It’s working a little better than we anticipated. Certainly, I think, working a lot better than many of the critics talked about early on.” By Christine Kern, contributing writer

CASE STUDIES & WHITE PAPERS

ABOUT ACCOUNTABLE CARE ORGANIZATIONS (ACO)

An Accountable Care Organization (ACO) utilizes a payment and care delivery system that bases payments to providers on quality metrics and seeks to reduce the total cost of care for a certain population of patients.  ACOs use a range of payment models and consist of groups of coordinated healthcare providers that provide care to groups of patients. ACOs are accountable to a third-party payer and the group of patients for the appropriateness, quality, and efficiency of the health services they provide.

In 2011, the Department of Health and Human Services (DHHS) set forth initial guidelines for ACOs to be created under the Medicare Shared Savings Program. These guidelines contained all necessary steps required for a physician, health care provider, or hospital to voluntarily participate in ACOs.

The quality measures used to evaluate an ACO's performance as defined by the Center for Medicare and Medicaid Services (CMS) fall into five domains. These domains are patient/caregiver experience, care coordination, patient safety, preventative health, and at-risk population/frail elderly health.

The three stakeholders in an ACO are the providers, payers, and patients. Providers are a network of hospitals, physicians, and other healthcare professionals. The primary payer is the federal government, Medicare, but also includes other payers such as private insurances or employee-purchased insurance. The patient population of an ACO will primarily consist of Medicare beneficiaries, but in larger ACOs can also include those who are homeless and uninsured.

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