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

  • From Milk Crates To Mobile IT: Hospice Improves Access To Patient Records On The Go

    Employees on the go know that handling documents in the field can be a difficult task – and perhaps no workforce knows this better than hospice caregivers. Hospice workers are road warriors who are constantly on the go to see patients in their homes, a job description that seemingly requires mobile technology.

  • One Year Away: Time For ICD-10 Test Flights

    Orville Wright designed, built, and tested the world’s first aircraft engine in six weeks. No manufacturers were willing to build Wright’s engine, so he built it himself. Four cylinders, 12 horses, and 200 pounds later, he placed the new engine into Flyer, the world’s first biplane. The rest is history. Likewise, the healthcare industry is fast approaching one of its greatest milestones — the transition to the ICD-10 code set. The move to ICD-10 signifies the largest financial system change since establishment of the Prospective Payment System (PPS) in 1983. However, unlike Mr. Wright, we have solid roadmaps to help build, design, and test our invention. By Wendy Coplan-Gould, RHIA, President, HRS and Elizabeth Stewart, RHIA, CCS, CRCA, Corporate Director of HIM, HRS

  • Accountable Care Trends, Strategies, And Best Practices

    This article provides advice on how private practices can merge health IT with payers, patient engagement, and liquid data to form accountable care organizations (ACOs).

CASE STUDIES & WHITE PAPERS

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.

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