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

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CASE STUDIES & WHITE PAPERS

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FROM THE EDITOR'S DESK

  • The Problem With Consumerism In Healthcare
    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.

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ACO PREMIUM CONTENT

  • A Road Map To Accelerating  Health IT Value And Innovation
    A Road Map To Accelerating Health IT Value And Innovation

    Health IT is in a state of constant evolution, and it often seems that, for every problem solved, another is created. That’s why it’s vital we stop to assess where the industry stands from time to time, as well as look to the future to determine the best course to take to achieve our collective goals.

  • Top 10 Health IT Trends For 2016
    Top 10 Health IT Trends For 2016

    For the past five years, EHR/MU was selected as the top health IT initiative for the coming year. This year, there’s a new top initiative, and what it is should come as no surprise.

  • Medical Moneyball — What Healthcare Stands To Learn From The Oakland A’s
    Medical Moneyball — What Healthcare Stands To Learn From The Oakland A’s

    With all the talk of Big Data, there are still big questions as to how to most effectively leverage information and data to make a positive impact on healthcare delivery, cost, and outcomes. One health system leader thinks an approach developed by a Major League baseball team might be a game changer.

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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

Lisa Tandy October 24 - 25, 2017
Electronic Benefit Verification & Prior Authorization Summit, CA
The Investigational New Drug (IND) Submission - Tips to Win the First Time October 26, 2017
1pm-2:30pm EST, Online Training
Adverse Event Reporting: Avoiding Common Pitfalls November 7, 2017
1pm-2:30pm EST, Online Training
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