Accountable Care Organization Archive

Setting Up an ACO: Who to Hire and Why

Setting up an Accountable Care Organization (ACO) can be a daunting task, to say the least. In addition to making sure that an ACO has complied with CMS guidelines/rules, a crucial component to getting started is hiring the best physicians. A recent article published by the American Medical Association highlighted the importance of hiring physicians

Money Up front: ACOs and The Advance Payment Model

Anticipating relatively high start-up costs, the Innovation Center of CMS developed the Advance Payment Model (APM) to complement the Shared Savings Program.  The APM is a limited model available to smaller ACOs that generally serve rural-based areas; however, the ACO may participate in either Shared Savings Program track. In order to qualify as an APM

Medicare Accountable Care Organizations: Steps to Getting Started

While the excitement surrounding Medicare Accountable Care Organizations (ACO) is clearly reverberating throughout the physician community, there continues to be a significant knowledge gap regarding the basic steps that must be taken to form an ACO. While a blog cannot provide a full step-by-step guide to ‘getting started’, I will address the relevant key considerations

CMS Penalties for Readmissions Create Additional Momentum Toward ACO Formation and EHR Utilization

Bonuses for successful accountable care organizations (ACO) have created quite a ‘buzz’ in the healthcare community. Two new developments – penalties for hospitals and quality of care data published online by the U.S. Department of Health and Human Services (HHS) – will build on this momentum and increasingly drive Accountable Care Organizations formation. Earlier this

Technology is Key to Achieving ACO Success

A study by America’s Health Insurance Plans (AHIP) found, “Technical assistance to providers has been identified as one of the key requirements to their success in accountable care arrangements.” See AHIP. MTBC’s suite of services is an ideal solution for providers interested in joining forces to create an Accountable Care Organization.  MTBC offers end-to-end revenue

Hospital Mergers & Acquisitions: Are ACOs a Cause or an Effect?

Over the last several years, the pace of mergers and acquisitions involving either hospitals purchasing physician practices or hospitals purchasing other hospitals has quickened exponentially. Some factors driving the consolidation in the healthcare industry are increasing overhead costs, decreasing reimbursement rates and hospitals’ reaction to the Patient Protection and Affordable Care Act (PPACA). What PPACA

CMS Pushing for Accountable Care Organizations

For those internet searching away for information on Accountable Care Organizations and the Medicare Shared Savings Program,  please ensure you are reviewing the final rules which were published on November 2, 2011.  The final rules relaxed many of the proposed rules in hopes of encouraging the formation of ACO.  One of the largest changes was

ACO: Creating a Strong Foundation with a EHR

Accountable Care Organizations (ACOs) are meant to be a flexible payment and care delivery model that lowers total cost of care for patients using a group of coordinated health care providers. Hay Greens, a healthcare policy practice, recently released an article that outlined five preparatory actions to create a stable ACO. This article informs providers

JAMA Study Concludes that ACOs are Poised to Improve Care and May Lower Costs

A study just published in the Journal of the American Medical Association (JAMA) suggests that the accountable care organization (ACO) model shows promise at improving quality of care and may provide some reduction in the rate of cost growth. On September 12, 2012, JAMA published the results of a study that examined the performance of

A Good Primer on Accountable Care Organizations

In anticipation of MTBC’s upcoming webinar on Accountable Care Organizations, I’d highly recommend reviewing Health Capital’s “Accountable Care Organization Series: Why Do We Need ACOs.” The series does a nice job explaining the history and basic principles of the concept. Accountable care organizations (ACOs) – in which health care providers take responsibility for a defined