Estes Park Medical Center selects HealthCare Anytime’s Enterprise Patient Portal citing “unique solution” and cloud platform By Wendy Grafius, contributing writer
State expects the community shared services platform will allow providers to exchange EMRs and will improve the quality, cost, and efficiency of healthcare By Katie Wike, contributing writer
Americans should expect to be able to buy health insurance through state HIXs beginning October 1st, but missed deadlines for security testing may make it a risky proposition By Katie Wike, contributing writer
Beacon programs showing HIEs provide value for healthcare industry By Katie Wike, contributing writer
Movement within the nation’s healthcare system has been swift and broad-‐based since the October 2011 Centers for Medicare & Medicaid Services (CMS) Shared Savings Final Rule.
Our population is becoming more mobile on a daily basis, and healthcare professionals are no exception. In fact, the very nature of the healthcare industry makes it ripe for a move to mobile. It also presents special implementation challenges.
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.
This success story from Greenway focuses on Dr. G. Edward Newman and his vision of a comprehensive, 21st century medical practice.
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.
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.
According to a new report, a lack of out-of-network interoperability is the biggest obstacle facing ACOs today. By Katie Wike, contributing writer