New Illinois ACO aims to realign focus to value of service with emphasis on improving health outcomes. By Wendy Grafius, contributing writer
Contrary to earlier fears that CPOE would cost hospitals more than it’s worth, new studies show it may actually save providers money over time By Katie Wike, contributing writer
In today’s medical industry, paper is becoming a thing of the past. In order to keep up with increasing medical costs, a rising number of patients, and rising patient demand for speedy information and billing, businesses must ensure their medical software is fully updated and optimized. But understanding the specific advantages associated with upgrading or implementing new software isn’t always easy. Even if you’re unsure of the best choices, don’t fret. Read on for the top three ways medical businesses may utilize the latest and greatest medical software services. By Sandra Mills, contributing writer
ACOs do not capitalize on savings opportunities, according to latest study. By Christine Kern, contributing writer
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?
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.
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.
According to a new report, a lack of out-of-network interoperability is the biggest obstacle facing ACOs today. By Katie Wike, contributing writer