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

  • Can Entrepreneurs Save Healthcare?

    I love to hear Jonathan Bush speak. Say what you will about his agenda as president and CEO of EHR vendor athenahealth, but the guy is a charismatic, passionate, and persuasive public speaker. When you hear Bush give a keynote, it’s clear he’s inherited much of the political swagger that runs in his bloodline (former president George H.W. Bush is his uncle and George W. Bush is his cousin).

  • EHRs More Accepted, But Not Yet Seamless

    With electronic health records soon to be federally mandated, healthcare professionals need to take care in choosing the one that suits them best By: Shannon Dauphin Lee

  • CPOE Reduces Errors – Why Aren’t More Providers Using It?

    Contrary to earlier fears that CPOE would cost hospitals more than it’s worth, new studies show it may actually save providers money over time By Katie Wike, contributing writer

CASE STUDIES & WHITE PAPERS

  • An Israeli Model For Coordinated Care This white paper illustrates how Maccabi Healthcare Services, the second largest health maintenance organization in Israel, aligned the proper incentives, processes, and IT assets to deliver coordinated care to more than 1.9 million members.
  • Leveraging Big Data And Analytics In Healthcare

    With the cost of mapping an individual human genome poised to break the $1,000 barrier – bringing personalized medicine closer to reality – the healthcare and life sciences industries are now grappling with managing the explosive growth of data.

  • Use IT To 'Disrupt' The Healthcare System This white paper captures the highlights of a presentation at HIMSS12 delivered by Eric Dishman, General Manager of Health Strategy and Solutions at Intel Corporation, and Jason Hwang, MD, executive director of healthcare at the Innosight Institute.
  • White Paper: Healthcare Business Insights: Social Media Strategy For Healthcare Vendors This white paper outlines how vendors in the healthcare space are using social networking sites to take relationship building to the next level, resulting in increased qualified leads, and, ultimately, a greater return on marketing investment. By Jennifer Dennard

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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