FEATURED ARTICLES: ACO
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OIG Says RACs And CMS Could Be Identifying Even More Fraud
OIG criticizes RAC program and CMS, concluding that CMS must do more to evaluate the effectiveness of the program and take action regarding improper payments By Greg Bengel, contributing writer
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Understanding Exchange Impact On Pharmaceutical Companies10/9/2013
A recent study says that pharmaceutical companies will see modest gains offset by discounts and rebates when the health insurance exchanges kick in. By Greg Bengel, contributing writer
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Top 10 Health IT Trends For 201611/24/2015
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.
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Paying Patients To Engage?11/20/2013
Physicians are offered incentives for meeting standards, is the solution to improving engagement offering patients the same deal By Katie Wike, contributing writer
CASE STUDIES & WHITE PAPERS
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5 Steps To Building An Effective Care Management Program7/1/2016
How to Create, Implement, and Operate a Successful Program.
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Enhance The Quality Of Care, While Reducing Costs9/6/2012
Read this analyst white paper, Sophisticated Solutions to Optimize Healthcare Delivery, and see how enterprise content management solutions can enable your organization to optimize patient care, reduce the cost of healthcare, and improve clinician satisfaction and overall organizational productivity.
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The Path to Population Health Management: Creating An IT Foundation For A Successful ACO10/22/2014
Healthcare organizations across the U.S. are investing significant resources in re-architecting their care delivery infrastructures to enable them to adapt successfully to new, value-based Accountable Care Organization (ACO) payment and delivery models. As these entities prepare to go “at risk” and take outcomes-based capitated or bundled payments, they face a broad set of challenges. These challenges range from acquiring or partnering for resources that will enable them to deliver and control the full continuum of care, to understanding their new cost structures and determining if they can survive and thrive financially in an ACO world.
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Reduce Readmissions By Automating Post-Discharge Care12/12/2011This white paper is aimed at helping facilities understand ways to eliminate systemic failures that begin in the hospital and then persist through fragmented healthcare settings.
FROM THE EDITOR'S DESK
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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.
FEATURED NEWS
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ACOs Face Interoperability Barriers2/8/2016
According to a new report, a lack of out-of-network interoperability is the biggest obstacle facing ACOs today. By Katie Wike, contributing writer
ACO NEWS ARTICLES
- Upcoming Webinar: Data-Driven Care: The Key To Accountable Care Delivery From A Physician Group Perspective
- 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