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Top 10 ACOs by Patient Population

May 17, 2018 BY Alanna Moriarty

Top 10 ACOs by Patient Population

An Accountable Care Organization (ACO) is a voluntary coalition of healthcare providers characterized by a care delivery and reimbursement model tying provider payments to quality metrics and patient care outcomes. The goal of the ACO model is to reduce total care costs for a specific patient population. Each ACO has a defined patient population for which it is held accountable in terms of care cost and quality. Patient populations are primarily comprised of Medicare beneficiaries.

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Can an ACO Benefit Independent Physicians?

February 21, 2018 BY Alanna Moriarty

Can an ACO Benefit Independent Physicians?

The Congressional budget deal passed earlier this month includes changes to the Medicare Shared Savings Program (MSSP), impacting ACOs participating in the initiative. One of the most prominent changes to the MSSP is the establishment of the ACO Beneficiary Incentive Program, which allows ACOs to pay patients up to $20 for making appointments with their primary care physician—much like the existing Coordinated Care Reward Program. The Beneficiary Incentive Program will also enable beneficiaries to select an ACO-affiliated physician as their primary care provider. Industry experts hope these changes will encourage beneficiaries to be more proactive and engaged in their own care.

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The Pivotal Role of Healthcare IDNs in Purchasing and Population Health

The Centers for Medicare and Medicaid Servces (CMS) is putting increasing pressure on healthcare providers to deliver high-quality care to patients at the lowest possible cost while simultaneously reducing preventable readmissions. Some care providers have joined accountable care organizations (ACOs) to meet these expectations. However, though ACOs are capable of providing coordinated, timely care, they have limitations as a group of individual providers, care centers, and health plans.

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CMS to Divulge Patient ACO Status

August 25, 2017 BY Alanna Moriarty

CMS to Divulge Patient ACO Status

In the wake of provider criticisms, CMS has updated how physicians will be made aware of which patients will be monitored for the Medicare ACO program.

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Commercial Groups Driving Force Behind ACOs Development

February 21, 2017 BY Definitive Healthcare

Commercial Groups Driving Force Behind ACOs Development

Accountable care organizations (ACOs) are often touted as the healthcare delivery model of the future. Though CMS’ Medicare Shared Savings Program gets lots of attention from analysts and the media, the real direction of ACOs is being determined behind the scenes in the private sector. Commercial ACOs cover millions of lives but are often overlooked because they have no public reporting requirements, their existence is not always announced, and rarely do providers or insurers give a complete account of their performance, unless one does especially well. However, they encounter some of the same obstacles: managing the challenges of value-based reimbursement, developing effective physician leadership, and determining the best way to use technology.

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