
FEATURED ARTICLES: ACO
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The ACO 'Guinea Pigs'
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
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IT: The Only Certainty In Healthcare's Future4/1/2011Dell’s survey indicates that much of the uncertainty in the industry is thanks to healthcare reform. For example, virtually all hospital executives surveyed are worried about how states will cope with an expanded role in healthcare financing through Medicaid and other programs required under reform.
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Hospitals Post Physician Ratings4/24/2014
Now, patients can find ratings and reviews of their physicians directly on many hospital websites. By Katie Wike, contributing writer
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60% Of Doctors Won't Join ACOs3/24/2014
Study finds that more than half of physicians have not joined ACOs. By Christine Kern, contributing writer
CASE STUDIES & WHITE PAPERS
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Achieving Success With The 5010 / ICD-10 Change-Over2/8/2012SuccessEHS is a nationally acclaimed vendor providing Electronic Health Record (EHR) and Practice Management solutions with Integrated Medical Billing Services.
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White Paper: Transforming IT For Accountable Healthcare5/5/2011This February 2011 white paper looks at the impact of ARRA and PPACA on provider organizations and the role IT can play in preparing healthcare providers for future success in the evolving landscape. An IDC Health Insights White Paper sponsored by HP
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IT Infrastructure: A Foundation For Accountable Care Organizations8/11/2011The advent of healthcare reform will require a health information technology infrastructure that integrates all the “moving parts” of an ACO, including hospitals, physicians, labs, outpatient centers, claims and analytics.
FROM THE EDITOR'S DESK
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Is Technology To Blame For Physician Burnout?
According to a recent Medscape survey, 46% of physicians say they are burned out. How much is the drive towards health IT adoption contributing to this epidemic?
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.
FEATURED NEWS
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Population Health Cuts Anthem ACO Costs By Nearly $8 Million6/30/2015
Anthem’s program provides doctors with additional payments if they lower the cost of patients’ care. By Christine Kern, contributing writer
ACO NEWS ARTICLES
- WEDI Releases Guide On HIPAA Transactions Requiring ICD-10 Codes
- Automated Quality Reporting Through EHRs Can Result In Significant Efficiencies And Care Improvements
- CMS Releases Updated Data On EHR Adoption
- West Florida ACO Chooses Sandlot Solutions As Partner In Patient Health Information Management
- Importance Of Evidence-Based Medicine Presented In New Issue Brief Available From Elsevier