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Accountable Care Organizations: An Overview

Accountable Care Organizations: An Overview • Recently made possible by the Affordable Care Act, Accountable Care Organizations are refocusing the priorities of the health care system by emphasizing coordinated, quality care. About Accountable Care Organizations - Accountable Care Organizations (AC0S) are groups of health providers like hospitals, doctors, and community health centers that voluntarily come together to give coordinated care to their Medicare patients. The goals of coordinated care: Helping patients get the right care at the right time Lowering costs Eliminating duplication of procedures Preventing medical errors When ACOS successfully provide excellent care while lowering costs, they share the savings with Medicare It is projected that Medicare could save as much as $940 million over 4 years with ACOS THESE ACOS COVER Since the passage of the Affordable Care Act, over more than 4 million beneficiaries nationwide 250 ACOS have been established About About O50% of ACOS are physician-led and serve less than 10.000 of ACOS include community health centers and critical-access hospitals that service low-income or rural areas beneficiaries - A New Way to Look at Health Care- COO Traditional structure: ACOS Doctors and health providers operate independently to provide care for patients in the moment change the focus of the medical structure V Rewards health practitioners for keeping beds full and doing as much as they can V Health providers work in concert to provide the best continuous care and avoid hospitalization V ACOS change the rewards of the medical structure V Rewards for keeping costs low and producing the best care and outcome 2 in 3 Americans older than 65 have multiple chronic conditions MULTIPLE = MULTIPLE = DISJOINTED conditions doctors care Beneficiaries with multiple chronic conditions account for 93% of Medicare fee-for-service expenditures Each year, an average of 1 in 7 Medicare patients are admitted to the hospital due to a medical error in their care Medical care is judged by 33 measures, covering: Care quality Patient safety 1 in 5 Preventive health services Improved care for at-risk populations Medicare patients discharged from the hospital are readmitted within 30 days Physician & caregiver experience of care Types of ACO Programs Medicare Shared Savings Program Advance Payment ACO Model Pioneer ACO Model Each ACO responsible for at least 5,000C DESIGNED for health care organizations and providers that are already experienced in providing coordinated care beneficiaries annually for a period of three years Provides coordinated care for Medicare fee-for-service beneficiaries Supports physician-owned and rural ACOS with UP-FRONT INFRASTRUCTURE INVESTMENTS so that they can provide coordinated care Expedited progression from Two sharing models Receives Shared savings payment model Population-based payment model payments in advance that are recouped as they achieve savings O Open only to One-sided sharing: ACOS only share in savings, up to Two-sided sharing: ACOS share in savings up to 50% 60% > Physician-owned organizations > Critical-access hospitals > Rural providers Works in coordination with private payers participating in the Shared Savings Program but also share in losses if costs rise -How ACOS Can Benefit Patients Hospitals and health care providers work together to provide coordinated care, which results in: Better communication between doctors, other health care providers, and patients Less time filling out paperwork, especially if doctors are using an electronic health record Fewer repeated medical tests, improved synchronicity with prescriptions, and overall better care due to shared information More transparency: patients will have access to information about how well their providers are meeting quality standards Patient-centered care based on effective outcomes and patient input And remember: Unlike HMOS, managed care, and some insurance plans, an ACO can't change your Medicare benefits or tell you what health provider to see Your medical information is protected by federal law, and only authorized medical staff will be able to access it Interested in getting involved in the health care revolution? A Master of Public Health can help you get there. Check out the University of Southern California's online MPH program from the Keck School of Medicine for more information. Sources: care-organization.html http://www.hhs.gow/news/press/2013pres/01/20130110a.html http://www.medicare,.guv/manage-your-health/coordinating-your-care/accountable-careorganizations.html Service-Payment/ACO/index.html?redirect-/aco carel0202011a.html http://innovation.cms.guv/initiatives/Pianeer-ACO-Model/index.html III

Accountable Care Organizations: An Overview

shared by monsieurnavarro on May 13
If you’re working towards a career in public health, you know how important Accountable Care Organizations can be. These are groups of health providers that voluntarily come together to give coordin...


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