What is the key component of an accountable care organization?

A key component of the ACO payment structure is financial risk. ACOs take value-based reimbursement to a new level by not only tying payments to quality, but also holding providers financially accountable for the care costs of their patient population. Financial risk in ACO contracts can be “upside” or “downside.”

What are the main principles of the accountable care organization model?

The design of an Affordable Care Organization is based on the principle that each provider will be held accountable for the cost and quality of the care provided, prevention of disease, and avoidance of waste.

What are the 3 types of Medicare accountable care organizations?

Overview: The largest effort in payment innovation in Medicare is a portfolio of accountable care organization (ACO) programs that include the Medicare Shared Savings Program (MSSP), Next Generation model, and Comprehensive ESRD model.

What are examples of accountable care organizations?

Some examples are Kaiser Permanente, Group Health Cooperative of Puget Sound, and Geisinger Health System. These systems typically have aligned financial incentives, electronic health records, team-based care, and resources to support cost-effective care.

What are the goals of ACOs?

Accountable Care Organizations (ACOs): General Information

Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors.

What are the benefits of ACOs for the health care industry?

ACOs are structured to create an incentive to be more efficient by offering bonuses when providers keep costs down. They must carefully manage consumers with chronic conditions, focusing on prevention, to impact utilization of services and reduce overall costs of care.

What are negatives of an ACO?

ACOs are expected eventually to take on downside risk.

Ultimately, if an ACO is unable to reduce the cost of patient care, there will be no savings to share. This can adversely affect an ACOs operating budget. Even worse, an ACO may have to pay a penalty if it doesn’t meet certain quality and cost-saving benchmarks.

Which of the following describes the role of an ACO?

The purpose of an ACO is to enable care coordination that allows a patient to receive the right care at the right time while reducing the risk of medical errors and duplicate services.

How do accountable care organizations improve quality of care?

ACOs have started to deliver higher care quality at lower costs by building their health IT infrastructure, developing population health management programs, optimizing post-acute care, and implementing other care and cost management strategies.

What is the purpose of an accountable care organization?

What is an ACO? ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.

What is the ACO reach model?

The ACO REACH model, which is an evolution of the Direct Contracting model, tests how providers can be incentivized to collaborate across multiple treatment plans, spend more time with patients with complex, chronic conditions and ultimately, improve patient health outcomes.

What is ACO payment model?

The ACO Investment Model was an initiative designed for organizations participating as accountable care organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program). The ACO Investment Model was a model of pre-paid shared savings that built on the experience with the Advance Payment Model.

What is an ACO and what values do they bring to patient care?

Accountable Care Organizations (ACOs): Groups of doctors, hospitals, and other health care professionals that work together to give patients high-quality, coordinated service and health care, improve health outcomes, and manage costs.

What are three responsibilities of ACO as it relates to the needs of Medicare beneficiaries during the minimal three year period?

CMS proposed a three-part aim for ACOs: (1) improve patient care; (2) improve health among various populations; and (3) reduce the cost of care to Medicare Parts A and B.

Can I opt out of ACO?

You may elect not to have your personal identifiable medical information shared with an ACO through the data opt-out process. For more information on this process and/or to obtain a data opt-out form please contact 1-800-MEDICARE.

What is direct contracting?

Direct Contracting (DC) is a set of voluntary payment model options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service (FFS).

What are ACO requirements?

An ACO must maintain an identifiable governing body with authority to execute the functions of an ACO, including but not limited to, promoting evidence-based medicine and patient engagement, reporting on quality and cost measures, and coordination of care.

What is a characteristic of an ACO quizlet?

ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and …

What are the hallmarks of the accountable care solutions?

A change in payment structure, better care coordination, augmented data, and improved care management—hallmarks of accountable care—could enable improvements in health and more efficient use of cardiology expenditures.

What are negatives of an ACO?

ACOs are expected eventually to take on downside risk.

Ultimately, if an ACO is unable to reduce the cost of patient care, there will be no savings to share. This can adversely affect an ACOs operating budget. Even worse, an ACO may have to pay a penalty if it doesn’t meet certain quality and cost-saving benchmarks.

Which problems would accountable care organizations ACO solve?

Accountable care organizations (ACOs) have been created to improve patient care, enhance population health, and reduce costs.