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Accountable Care Organization

What is an Accountable Care Organization (ACO)?

An Accountable Care Organization (ACO) is a group of healthcare providers who agree to be jointly accountable for both the quality and the cost of the healthcare of a defined patient population.

Although the concept of an Accountable Care Organization has been around for some time, The Patient Protection and Affordable Care Act of 2010 (PPACA) really set the stage for the ACO paradigm. The Centers for Medicare and Medicaid Services has launched a number of programs which reward qualifying ACO’s with a share of any savings that the Accountable Care Organizations realize, the most prominent among them being the Medicare Shared Savings Program (MSSP). Over 150 Accountable Care Organizations have been formed under the various CMS programs (including The Pioneer Program, The Advanced Payment Program and the Shared Savings Program). To learn more about the ACO model, please read our blogs or watch the webinar series.

Establishing a Successful ACO and How MTBC Can Help?

The overarching objective of the ACO model is to bring about a reduction in costs while increasing the quality of healthcare. There are many intricacies involved in setting up and managing a successful Accountable Care Organization. Further, if an ACO wishes to participate in the Medicare Shared Savings Program (MSSP), in addition to generating sufficient cost savings, the ACO must demonstrate the achievement of 33 quality measures.

Underlying all this complexity is a core set of components. The success of any Accountable Care Organization depends upon recognizing these and weaving them into its fabric. Unfortunately, the delivery of these systems requires an ACO to invest heavily in Information Technology. The IT infrastructure needed is both costly and risky because the technology is not only complex, it is continuously evolving too. That is where MTBC can help. Our web-based EHR, practice management and patient engagement and communication solutions provide ACO’s with a low cost and low-risk turnkey alternative.

Coordination and Integration: An ACO cannot operate on an encounter based model; it must adopt the principles of population management. As healthcare providers across the healthcare continuum collaborate, coordination becomes crucial. Numerous healthcare partners across the continuum need to be able to access the same information, both within and outside the ACO. At every point throughout the continuum, healthcare providers need to have the most up-to-date information on the patient they are attending. Further, coordination is required between the Accountable Care Organization and external partners such as labs and pharmacies.

MTBC WebEHR provides seamless integration of all the ACO’s healthcare partners. It allows for the capture of all relevant clinical and financial information at the point of care and for its subsequent dissemination to all the necessary healthcare participants across the continuum. It ensures that the right information is captured and delivered to the right parties at the right time and in the right form. Even if all ACO participants are not using the MTBC WebEHR, our robust interfacing and HIE capabilities allow us to transparently bridge the disparate systems to achieve true consolidation, coordination and integration.

Patient-centeredness and engagement: The Medicare Shared Savings Program (MSSP) puts the welfare of the patient at the heart of the ACO philosophy. Accountable Care Organizations must look beyond just attending to patients at distinct points of care. They must engage patients in the decision making process. They must strive to effectively communicate relevant information to their patients, to educate them about their health and to support patient self-service. In short, ACO’s must involve patients in their own care.

MTBC’s WebEHR and Patient Portal have all the tools needed to accomplish the MSSP’s patient engagement requirements and more. Online appointment scheduling, Appointment reminder calls, Patient check-in Kiosk, electronic billing, wellness reminders (such as flu shot reminder calls), Patient help desk, online Patient Portal, integration with MedlinePlus patient education resource. These and other tools ensure that the ACO covers the full spectrum of patient engagement activities.

Reporting and Analytics:

An ACO is required to not only increase quality and reduce costs but to report on its success too. The Medicare Shared Savings Program (MSSP) requires Accountable Care Organizations to measure and report on 33 quality measures. However, successful ACO’s will be those which use the vast amounts of data at their disposal to drive performance measurement and improvement, beyond merely fulfilling the formal MSSP requirements. It is not just about reporting, it’s about analyzing data, turning it into information and subsequently disseminating that information to the right people at the right time and in the right form, to inform decision making at all levels within the ACO. This includes but is not limited to financial measurement and reporting, analysis of clinical data to support point of care automation and evidence-based medicine and personnel performance monitoring etc.

MTBC’s advanced reporting and analytical tools cater to all these reporting and analysis needs. These tools cover the entire spectrum of financial and clinical reporting and analysis requirements, from granular line item level details to management level dashboards and summaries. These tools are designed to facilitate all ACO participants ranging from health care providers to senior ACO management.

To find out more about how MTBC may assist you Contact Us.