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

  • Hospitals Move To Put Doctors In Charge

    As the Affordable Care Act forces hospitals to focus more on quality of care and transparency, many feel more physicians need to take on leadership roles By Greg Bengel, contributing writer

  • Mobile Health Apps: Safe And Effective?

    Prescribing mobile apps for chronic conditions is gaining in popularity; providers now need to ensure the apps’ safety and quality By Katie Wike, contributing writer

  • 1 In 6 EHR Users Considering Switching

    A poll by Black Book Rankings found many providers are leaving their current EMR systems for web based alternatives By Katie Wike, contributing writer

  • ONC Sets Goals For MU Stage 3

    The Meaningful Use Workgroup is designing Stage 3 of Meaningful Use with a focus on connecting functionality and outcome By Katie Wike, contributing writer

CASE STUDIES & WHITE PAPERS

  • Keep Ahead Of The 5010 And ICD-10 Curve

    This paper examines the impact of the 5010 and ICD-10 initiatives from a strategic standpoint. The objective is to ensure compliance with federal regulations, while considering synergies around MU, business intelligence (BI) and business performance management (BPM) and resource maximization.

  • One Practice’s Journey To Accountable Care This white paper chronicles how New Pueblo Medicine, an independent practice of seven internal medicine physicians based in Arizona, is delivering team-oriented, prevention-focused care with tighter coordination across the continuum of care, while responding to regulatory and compensation pressures and remaining a small independent practice.
  • Enabling Collaborative Healthcare Delivery: Care Coordination Strategies With 21st Century Technology In 2003, the Institute of Medicine (IOM) identified care coordination as one of its 20 national priorities for quality. Since then, other prominent organizations, such as the Centers for Medicare and Medicaid Services (CMS), the Commonwealth Fund, the National Quality Forum, and the World Health Organization, have recognized care coordination as a key component for improving healthcare delivery. By Intel
  • White Paper: Becoming A Medical Home Transforming your practice into a medical home won’t require a down payment on new space – nor a remodel of the reception area. By Sage

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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