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

  • How Telehealth Is Driving Engagement And Shaping The ACO Model Of The Future

    The U.S. healthcare industry is rapidly transitioning beyond the traditional focus of treating individual patients’ physical conditions. Accountable Care Organizations (ACOs) and similar arrangements are leading the way, structured specifically to reward progress toward achieving the Triple Aim of improving the patient experience, improving the health of populations and reducing the cost of care. Fully addressing these dynamics By Derek Richards, PhD, director of clinical research and innovation, SilverCloud Health

  • The Care Continuum Wars
    3/15/2012

    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

  • ACO Cost-Sharing Subsidies Should Alleviate Payment Fears
    7/21/2014

    Cost-sharing subsidies take up slack of payments for many ACO patients. By Christine Kern, contributing writer

  • ACOs To Cover 130 Million By 2017
    7/31/2014

    Parks Associates predicts more than 130 million patients will receive care from an accountable care organization by 2017. By Katie Wike, 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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