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

  • Accountable Care Organization Technology Framework
    2/20/2014

    The “accountable care organization” (ACO) is a major topic of discussion in American health policy. While the ACO label has been around since 2006, it was mentioned in numerous healthcare reform bills proposed in 2009 and was ultimately included in Section 3022 of the Patient Protection and Affordable Care Act (ACA) as the Medicare Shared Savings Program. The ACA’s ACO provision covers Medicare ACOs.

  • From Customization To Collaboration: Matching Mobile Devices To Clinicians’ Workflow
    8/29/2012

    This white paper from Intel discusses mobility in the healthcare industry and selecting the right mobile solution.

  • 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.
  • What You Need To Know In Replacing An EHR
    11/5/2011

    This independent mixed case study and white paper performed at the request of Greenway Medical Technologies provides an independent in-depth analysis of how Greenway’s services, solutions, and technology are helping medical practices undergo EMR-to-EHR conversions.

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.

INDUSTRY EVENTS

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