Accountable Care Organzations ACO

According to Healthcare.gov

Accountable Care Organizations: Improving Care Coordination for People with Medicare

The Affordable Care Act includes a number of policies to help physicians, hospitals, and other caregivers improve the safety and quality of patient care and make health care more affordable. By focusing on the needs of patients and linking payments to outcomes, these delivery system reforms will help improve the health of individuals and communities and slow cost growth.
On March 31, 2011, the Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).

Need for and Benefits of Coordinated, Accountable Care

About Accountable Care Organizations
Under the proposed rule, an ACO refers to a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve with Original Medicare (that is, those who are not in a Medicare Advantage private plan). The goal of an ACO is to deliver seamless, high quality care for Medicare beneficiaries. The ACO would be a patient-centered organization where the patient and providers are true partners in care decisions.

The Affordable Care Act specifies that an ACO may include the following types of groups of providers and suppliers of Medicare-covered services:
•ACO professionals (i.e., physicians and hospitals meeting the statutory definition) in group practice arrangements,
•Networks of individual practices of ACO professionals,
•Partnerships or joint ventures arrangements between hospitals and ACO professionals, or
•Hospitals employing ACO professionals, and
•Other Medicare providers and suppliers as determined by the Secretary.

Sharing Savings Shared Savings Program details, visit www.ftc.gov/opp/aco/.

Measuring Quality ImprovementThe rule proposes quality measures in five key areas that affect patient care:
•Patient/caregiver experience of care;
•Care coordination;
•Patient safety;
•Preventive health; and
•At-risk population/frail elderly health.

The proposed rule sets out proposed performance standards for these measures and a proposed scoring methodology, including proposals to prevent providers in ACOs from being penalized for treating patients with more complex conditions.

Additional Topics covered in the article are:
Improving Care for Patients
Antitrust Guidance for Providers in ACOs
One Part of Quality Improvement

To read this article in full visit Healthcare.gov

To inquire about jobs visit Melnic Consulting Group or contact:Jill Gilliland800-886-7906jill@melnic.com

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