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

CASE STUDIES & WHITE PAPERS

  • Where Information And Care Meet: Secure Mobile Healthcare Solutions That Drive Care Coordination
    11/10/2011
    Mobile technology has long reached critical mass in the United States. Four of five American adults, or 83 percent, own some kind of cell phone, according to the August 2011 report, Americans and Their Cell Phones, by the Pew Research Center’s Pew Internet and American Life Project.
  • White Paper: Providing Accountability: Accountable Care Concepts For Healthcare Providers
    4/5/2011
    Healthcare expenditures in the United States totaled $2.5 trillion in 2009. Researchers estimate as much as 30 percent of those costs, or $750 billion, may have been due to overuse, underuse, misuse, and/or inefficiencies of healthcare services. By RelayHealth
  • Brigham And Women’s Hospital Saves Over $9M, Improves MT Productivity 123%
    4/16/2012

     

    A 730-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners Healthcare System, Brigham and Women’s Hospital is a world leader in patient care and research. The organization wanted to upgrade its existing transcription process to eliminate multiple medical transcription service
    organizations (MTSOs) contracts and to address increasingly complex technical and billing infrastructures. The expensive, slow system hampered clinicians’ ability to maximize use of transcribed reports to diagnose and plan patient care.
  • An Israeli Model For Coordinated Care
    4/5/2012
    This white paper illustrates how Maccabi Healthcare Services, the second largest health maintenance organization in Israel, aligned the proper incentives, processes, and IT assets to deliver coordinated care to more than 1.9 million members.

FROM THE EDITOR'S DESK

  • The Problem With Consumerism In Healthcare

    Many industry leaders championed a free market approach to healthcare during the 12th Annual World Health Care Congress last week. Here are a few key reasons why I don’t think this model is “the fix” our industry so desperately needs.

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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