FEATURED ARTICLES: ACO
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.
HHS Aims To Reduce Health IT Errors
New plan to guide health IT provides venue for clinicians to report incidents using CEHRT By Lisa Kerner, contributing writer
Physician ICD-10 Readiness Less Than 10%
ICD-10 readiness has been in question throughout the implementation process and new data shows less than 10% of practices are ready for the switch By Katie Wike, contributing writer
VHHA Moves Towards Meeting MU
Virginia Hospital & Healthcare Association aims to satisfy meaningful use patient engagement requirement with implementation of interactive health management system. By Wendy Grafius, contributing writer
CASE STUDIES & WHITE PAPERS
The Path to Population Health Management: Creating An IT Foundation For A Successful ACO
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.
St. John Medical Center Uses A Team Approach To Ensure Successful Implementation Of New Electronic Health Record Initiative
As new value-based payment models emerge in the healthcare industry, hospitals that demonstrate high-quality, efficient patient care will have a distinct advantage over those organizations that remain mired in unwarranted variation in care processes, unnecessary and duplicative tests, and an inability to coordinate care.
Novant Health Reduces Transcription TAT From Days To Hours, Doubles MT Productivity
Novant Health’s 1,117 physicians, 13 hospitals, and 360 clinic locations serve more than 3.5 million patients from Northern Virginia to Georgia. Efficient, accurate capture and transfer of information from more than 1,500 dictating clinicians enables award-winning levels of quality and care.
Accountable Care Trends, Strategies, And Best Practices
Movement within the nation’s healthcare system has been swift and broad-‐based since the October 2011 Centers for Medicare & Medicaid Services (CMS) Shared Savings Final Rule.
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.
ACOs Face Interoperability Barriers
According to a new report, a lack of out-of-network interoperability is the biggest obstacle facing ACOs today. By Katie Wike, contributing writer