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

  • Preparing HIEs For Disaster

    In the event of a hurricane or other wide-spread disaster, 10 states have aligned to ensure their residents’ health information will still be available By Katie Wike, contributing writer

  • Why Measurement Matters

    Healthcare Business Intelligence (BI) & Analytics have been in the spotlight recently, and they will continue to be a top priority for healthcare organizations. But the focus of BI and analytics is changing – from implementation to leveraging data to drive improvements in the delivery of healthcare. By Stacy Humphrey, director of product marketing, Dimensional Insight

  • Can Providers Keep Up With MU?

    At the Senate Finance Committee hearing on health IT, one senator suggests suspending MU for reassessment, while witnesses fear a pause would stop provider momentum By Greg Bengel, contributing writer

  • Implementation Earns Hospital HIMSS Analytics Stage 7 Award

    Hilo Medical Center adds paperless solutions to EHR, rewarded with Stage 7 Award by HIMSS Analytics By Wendy Grafius, contributing writer

CASE STUDIES & WHITE PAPERS

  • Managing Healthcare Data Within The Ecosystem While Reducing IT Costs And Complexities

    At the 2011 conference, EMC's team of healthcare solution specialists spoke with several vendors and conferees and asked one question: "What is the best way to reduce costs and complexity in a healthcare IT infrastructure?" The overwhelming answer was to enable a cloud environment for patient data and to find a solution for managing so-called "big data."

  • 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.

  • PrimeSUITE Implementation Boosts Important Metrics At Birmingham Heart Clinic

    This case study from Greenway covers the Birmingham Heart Clinic, a nine provider cardiology practice established in 1994, and how it was able to boost charge capture, pre-provider income, and patient visits during the inaugural deployment year of PrimeSUITE®.

  • The Direct Evolution: Why It Will Change How You Communicate

    What is Direct? Does it replace a HIE? Is it redundant with HL7 or XDS functionality? If I use email rather than Direct am I out of compliance with HIPAA?

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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