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Accountable Care Organization. HealthCare.gov Accountable Care Organizations : Improving Care Coordination for People with Medicare. Need for Coordination of Care. Provider focus of activity Patient Obligations absent

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Accountable care organization

Accountable Care Organization

HealthCare.gov

Accountable Care Organizations: Improving Care Coordination for People with Medicare


Need for coordination of care
Need for Coordination of Care

  • Provider focus of activity

  • Patient Obligations absent

  • Implied goal to reduce re-admissions and save $960 Million per year via aggressive outside of hospital care.


Goals
Goals

  • Deliver seamless, high quality care.

  • Patient centered

  • Patient and providers are partners in care decisions.

  • Partnership in responsibility and economic risk is absent.


Shared savings
Shared Savings

  • Risk model of capitation? FFS? Care Management? Shared savings?

  • Linkage between physicians in hospitals is implied but not specific.

  • Need for large, sophisticated physician group practice arrangements.

  • 5000 beneficiaries for at least three years

  • Medicare beneficiaries on the ACO Governing Board.

  • Beneficiary assignment vs. attribution


Measuring quality improvement
Measuring Quality Improvement

  • Auditable reporting of performance on over 30 quality metrics.

  • Reports on provider performance.

  • Options to select out of network providers?


Take away points
Take Away Points

  • ACO’s have a low probability of adoption in Alaska. HMO’s and capitated products never gained acceptance in this market.

  • Few communities in Alaska have the infrastructure and continuum of care to embrace ACO’s as a delivery model.

  • Low probability of provider acceptance.

  • Very high economic exposure to out of network expenses.


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