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

  • The Secrets Of Successful Patient Engagement

    Florida Hospital Celebration Health credits the right mix of process change and technology for a patient engagement effort that has resulted in improved staff communication and patient pain control.

  • Legislation To Mandate Patient Monitoring, Nurse Staffing Proposed
    8/14/2013

    The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 intends to enforce minimum nurse to patient ratios and mandate available technology in order to provide the best care possible By Katie Wike, contributing writer

  • The Quest For Evidence At HIMSS14
    3/5/2014

    A clear sense of urgency to gather actionable health data that improves care and cuts costs was on display at this year’s HIMSS conference. Here are a few of my key observations and takeaways from the event.

  • Charting A Course For Patient Safety
    3/12/2014

    Ten percent of diagnoses are wrong, delayed, or missed. What can be done to correct this problem and save the 40,000 or more lives that are lost each year as a result? By Melissa Cole, BSN, MSW, FACHE

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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