Wednesday, June 22, 2011

Why ACOs Are Like Oakland

The implications of the accountable care organization, or ACO, in healthcare are far-reaching. The ACO federal rules are defined in 429 pages provided by the Centers for Medicare and Medicaid Services at the end of March 2011.

Here are a couple of interesting excerpts from a post that thoroughly addresses the topic of ACO's including what is currently there and what is not:

"Under the rubric of "Medicare Shared-Savings Programs," an ACO was defined in the PPACA as a group of health care providers—it could be a physician group; a network of medical practices; a joint venture or partnership among a hospital, community physicians and ancillary providers; or a hospital that employs them—working together under shared governance with primary care physicians in the leadership role, managing and coordinating care for at least 5,000 Medicare fee-for-service beneficiaries."
"An ACO will need processes to measure and report the quality and cost of its care and to promote evidence-based medicine from outpatient disease prevention and health maintenance, through hospital admission, to post-discharge community follow-up. Mature ACOs will be paid by CMS for episodes of care rather than for à la carte services, and the ACO will be responsible for distributing the payments among its providers, dividing any savings realized through care improvement as bonuses."
This article draws the comparison between ACOs and Oakland by contending that "like the city of Oakland in Gertrude Stein's famous putdown—there's no there there."

Healthcare organizations need to implement processes and systems to measure and report the quality and cost of the care they are providing while promoting evidence-based medicine. Cloud-based solutions (including hc1.c0m) are the ideal way to address these challenges as they can be designed to span the continuum of care and unite all of the information silos and disjointed processes enabling this type of monitoring and measurement.

See the entire post in Hospitals & Health Networks (H&HN) here - Why ACOs Are Like Oakland

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