Accountable Care Organization, Healthcare Big Data, Healthcare Portal, and ACO Implementation Resources Accountable Care Organization, Healthcare Big Data, Healthcare Portal, and ACO Implementation Resources


  • The Care Continuum Wars

    Lines are beginning to blur between health insurers and hospital systems, as both parties battle it out to control their own autonomous patient care networks. By Ken Congdon, editor in chief, Health IT Outcomes

  • HIPAA Breach Exposes 42,000 In Wisconsin

    Unity Health Plans reveals breach of health care records, affects some 42,000 individuals Christine Kern, contributing writer

  • Patient-Centered Transplant Care — A Guiding Light For Accountable Care
    The identification, surgical intervention, management and lifetime clinical maintenance of transplant recipients are a case study of the needs around chronic disease management and collaborative care. By Paul Markham, MBA


  • Even A 60-Year-Old Multi-Specialty Practice Can Succeed With EHR

    After 60+ years in operation, The Veranda multi-specialty practice wanted a solution that would include an integrated electronic health record (EHR)/practice management (PM) solution, as well as one that could support multiple specialties as the practice considered growing outside of its OB/GYN roots.

  • Is The U.S. Ahead Of The Connected Healthcare Curve?

    In the United States, more patients can access their health records online than in many other countries. Does this mean that we are ahead of the connected healthcare curve? This study helps to shed some light on the subject.

  • Cost Fears Not Slowing Wireless Growth In Healthcare

    As healthcare organizations develop strategies to comply with federal mandates and succeed in the new environment, wireless is one of the emerging technologies that can enable organizations to meet their clinical and business objectives, especially in this era of having to do more with a finite set of resources.

  • Accountable Care Organization Technology Framework

    The “accountable care organization” (ACO) is a major topic of discussion in American health policy. While the ACO label has been around since 2006, it was mentioned in numerous healthcare reform bills proposed in 2009 and was ultimately included in Section 3022 of the Patient Protection and Affordable Care Act (ACA) as the Medicare Shared Savings Program. The ACA’s ACO provision covers Medicare ACOs.


  • 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.


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.