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

  • CMS Delays Two-Midnight Rule Again
    CMS Delays Two-Midnight Rule Again

    CMS announces six-month delay in implementing Two-Midnight Rule, now slated to happen October 1. By Christine Kern, contributing writer

  • AMA, Obama Administration Battle Over ICD-10

    The American Medical Association wants the ICD-10 transition deadline extended - or at least some enforcement concessions made - while the Obama administration is firm in its insistence that it will stay as is. Who will blink first? By John Oncea, Editor, Health IT Outcomes

  • Can Telemedicine Be Legislated?

    Florida lawmakers are leading a push for increased use of and payment for telemedicine By Katie Wike, contributing writer

  • ACOs: Healthcare’s Future, Or An Inevitable Failure?

    The term Accountable Care Organization has been around since 2006 and, in 2009, became part of the healthcare industry landscape when it was included in the Patient Protection and Affordable Care Act. BerylHealth created this infographic which provides a wealth of ACO-related information from the amount of the U.S. GDP spent on healthcare (15%) to the number of quality measures ACOs are measured on (33). By John Oncea, editor, Health IT Outcomes

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CASE STUDIES & WHITE PAPERS

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FROM THE EDITOR'S DESK

  • The Problem With Consumerism In Healthcare
    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.

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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

Chief Nursing Officer Summit 2019 September 16 - 17, 2019
Scottsdale, AZ
Healthcare Chief Medical Officer Summit 2019 September 16 - 17, 2019
Scottsdale, AZ
The 5TH MENA Health insurance congress October 1 - 3, 2019
Dubai
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