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

  • 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

  • 8 Musts For Community Healthcare Providers' 2015 IT Plan
    1/7/2015

    If you are a community healthcare provider, you have just been through a time where the pace of change and confusion couldn’t be greater. Predicting the future can literally mean trying to understand what is going to be different in just six short months from now. The old notion of a five-year strategic plan has gone out the window in favor of one-year action plans. Simply put, there is a “new normal” that we must accept related to pace of change. In light of that, I’d like to offer a few thoughts on what you might expect to incorporate into your IT Plans for 2015. By Phil Stravers, ICE Technologies, Inc.

  • HIE Platform Creates Population Management Ready Infrastructure
    4/7/2014

    Radiology service aims to develop an HIE infrastructure and enhance regional care coordination with implementation of comprehensive HIE platform. By Katie Wike, 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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