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Presentation transcript:

Accountable Care

Accountable care organization 1 An 'accountable care organization' (ACO) is a healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients

Accountable care organization - History 1 Accountable Care Organizations, Explained

Accountable care organization - History 1 Medicare announced 32 ACOs in December 2011,[ ACO-Model/ Pioneer ACO Model] 27 in April 2012,[ asp?Counter=4334 FIRST ACCOUNTABLE CARE ORGANIZATIONS] nearly 90 in July 2012,[ asp?Counter=4405 CMS NAMES 88 NEW] and over a hundred in January 2013.[ Service-Payment/sharedsavingsprogram/News.html Program News and Announcements] The complete list of ACOs[ Accountable Care Organizations] has providers in most states.

Accountable care organization - Cost savings 1 Medicare Shared Savings Program:Accountable Care Organizations; Proposed Rules

Accountable care organization - In the Affordable Care Act 1 What Providers Need to Know: Accountable Care

Accountable care organization - In the Affordable Care Act 1 Medicare Shared Savings Program: Accountable Care Organizations; Proposed Rules

Accountable care organization - In the Affordable Care Act 1 A National Strategy to Put Accountable Care Into Practice

Accountable care organization - In the Affordable Care Act 1 Medicare Shared Savings Program: Accountable Care Organizations; Proposed Rules

Accountable care organization - In the Affordable Care Act 1 After the initial set of regulations released in March, 2011, CMS received feedback regarding streamlining the governance and reporting burdens and improving the potential financial return for ACOs willing to make the necessary, and often substantial, investments to improve care.Health Policy Brief: Accountable Care Organizations, Health Affairs, July 27,

Accountable care organization - In the Affordable Care Act /october/20/accountable-care- organization-rules- regulations.aspxProposed Rule versus Final Rule for Accountable Care Organizations in the Medicare Shared Savings Program

Accountable care organization - ACO Payment Models 1 Medicare Program: Medicare Shared Savings Program: Accountable Care Organizations

Accountable care organization - ACO Quality Measures 1 To address the goal of improving healthcare quality, CMS has established five domains in which to evaluate the quality of an ACO’s performance. The five domains are patient/caregiver experience, care coordination, patient safety, preventative health, and at-risk population/frail elderly health. Department of Health and Human Services: Centers for Medicare and Medicaid (2011). Medicare Program: Medicare Shared Savings Program: Accountable Care Organizations. Federal Register. p

Accountable care organization - Providers 1 Accountable Care Organizations: A new model for sustainable innovation

Accountable care organization - Patients 1 An ACO’s patient population will primarily consist of Medicare beneficiaries. In larger and more integrated ACOs, the patient population may also include those who are homeless and uninsured. Patients may play a role in the healthcare they receive from their ACOs by participating in their ACO’s decision-making processes.Springgate, B.F., Brook, R.H. (2011). Accountable Care Organizations and Community Empowerment. Health Affairs. p

Accountable care organization - ACO Pilots and Learning Networks 1 Health Policy Brief: Accountable Care Organizations

Accountable care organization - Challenges 1 Department of justice/federal trade commission issue final statement of antitrust policy enforcement regarding accountable care organizations

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