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Provider Innovations: PCMH & ACO’s

Provider Innovations: PCMH & ACO’s. Accountable Care Organization (ACO). What is it and what qualifies? Differences between an ACO and an insurance company The CMS Model Roles of a payer and partner Threats and opportunities. Examples / Case Studies Comparison to failure of the 1990’s

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Provider Innovations: PCMH & ACO’s

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  1. Provider Innovations: PCMH & ACO’s

  2. Accountable Care Organization (ACO) • What is it and what qualifies? • Differences between an ACO and an insurance company • The CMS Model • Roles of a payer and partner • Threats and opportunities

  3. Examples / Case Studies • Comparison to failure of the 1990’s • How does Medical Home fit? • Keys to an ACO relationship • Financial • Roles • Governance

  4. Shifting Accountability • Potential Customers • Questions?

  5. Patient Centered Medical Home (PCMH) • History • Attributes • Axis’ of change • Physician involvement • Chronic diseases • NCQA Certification

  6. Communication • Continuity of Care • Results • Conclusion • Questions

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