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 ACO 'Guinea Pigs'

    On December 19, 2011, the Centers for Medicare and Medicaid Services (CMS) selected 32 healthcare systems to take part in the new Medicare Pioneer accountable care organization (ACO) initiative. 80 systems actually submitted formal applications to take part of the program. By Ken Congdon, editor in chief, Health IT Outcomes

  • IT: The Only Certainty In Healthcare's Future
    4/1/2011
    Dell’s survey indicates that much of the uncertainty in the industry is thanks to healthcare reform. For example, virtually all hospital executives surveyed are worried about how states will cope with an expanded role in healthcare financing through Medicaid and other programs required under reform.
  • Hospitals Post Physician Ratings
    4/24/2014

    Now, patients can find ratings and reviews of their physicians directly on many hospital websites. By Katie Wike, contributing writer

  • 60% Of Doctors Won't Join ACOs
    3/24/2014

    Study finds that more than half of physicians have not joined ACOs. By Christine Kern, contributing writer

CASE STUDIES & WHITE PAPERS

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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