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

  • ACOs To Cover 130 Million By 2017

    Parks Associates predicts more than 130 million patients will receive care from an accountable care organization by 2017. By Katie Wike, contributing writer

  • ACOs Struggle With Tech Adoption
    8/19/2014

    A survey from the eHealth Initiative shows ACOs have made little HIT progress in the last year. By Katie Wike, contributing writer

  • The ACO 'Guinea Pigs'
    1/12/2012

    On December 19, 2011, the Centers for Medicare and Medicaid Services (CMS) selected 32 healthcare systems to take part in the new Medicare Pioneer accountable care organization (ACO) initiative. 80 systems actually submitted formal applications to take part of the program. By Ken Congdon, editor in chief, Health IT Outcomes

  • Privacy, Security, HIPAA Compliance And A $5 Billion Crime Scheme
    10/17/2014

    Utter the acronym HIPAA to people in the medical profession and you will get a variety of facial responses, none of which have been, in my experience, a smile of contentment. Indeed, HIPAA’s privacy and security rules are often grumbled about as being burdensome and restrictive. The rules are increasingly criticized as ineffective these days and people are asking: How can an entity be HIPAA compliant and still suffer a breach of protected health information? By Stephen Cobb, Senior Security Researcher, ESET

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.

INDUSTRY EVENTS

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