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Accountable Care Organization. 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

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.
  • 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.