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ACO

ACO Defined

  • An accountable care organization is a group of payers, physicians, hospitals and other healthcare providers that voluntarily collaborate to provide efficient, high-quality and coordinated care to an assigned population of patients.
  • If providers reduce costs and/or improve specified quality metrics in a certain timeframe, they are able to receive financial rewards from or share in the savings with Medicare or a commercial payer.
  • Under the Medicare Shared Savings Program, providers must make a three-year commitment to care for a group of at least 5,000 Medicare beneficiaries.

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Common Myths Addressed

  • You do not need to be a large organization with a significant market share to take advantage of an ACO structure. In fact, due to the flexibility of smaller practices, groups of smaller practices are typically successful at establishing fruitful ACOs.
  • Employing physicians to be part of an ACO is not always the preferred method. Rather, physicians who voluntarily join an ACO – and therefore share in Medicare savings – are more likely to meet quality measures.
  • You do not need an extremely strong financial position to participate in or form an ACO. There are a multitude of methods to subsidise the startup costs associated with an ACO formation.

What EHI offers an ACO

  • Electronic Health Records Systems – An EHR with ACO/PCMH Capabilities will lead to better/easier care coordination, real-time monitoring, Quality Assurance measures, and reporting capabilities.
  • Personal Health Record Portal - An interactive, standards based PHR is pre-requisite for better Provider - Patient Communication. This also enables Patient to take responsibility for their health in a comprehensive manner enabling Physicians to better manage care for patients with Chronic Diseases.
  • Physician Portal and Health Information Exchange - Participating Physicians in the ACO are required to use a comprehensive portal to communicate between Physicians, Patients, and facilitate ease of communicating CCR. EHI provides this portal and information exchange capabilities.

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Elements of a Successful ACO

  • Health Information Technology:
    • EHR and Personal Health Record Portal
    • Physician Portal & HIE; Telemedicine Capabilities
    • Clinical and Commercial Data Analytical Tools & Systems

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