Accountable Care Organizations

Calculating Provider Revenue Loss in an ACO

Current healthcare literature is replete with recommendations for providers who are interested in pursuing participation in accountable care organizations. These articles typically focus on aligning payment incentives, developing care models, designing information systems to report quality measures and identify potential high-cost patients, and describing the dire consequences that will befall hospitals that don't participate in ACOs.

Dissecting DRGs for Bundled Payment

“Analytics for ACOs” Articles

Singletrack Analytics has written a number of articles relating to the analytical capabilities that will be required by accountable care organizations and other population-based risk-assuming organizations. A collection of those articles is linked below:

Analytics Challenges for Advanced Payment Systems

We've frequently commented on the need for up-to-date skills and computer hardware and software to be able to analyze the data that accompanies participation in capitated and bundled payment programs.  This HIMSS article highlights some of those issues and the barriers that they present to successful participation.

The Strange Financial Interactions Between Medicare ACOs and Bundled Payment Participants

Emerging Payment Models for ACOs and Bundled Payments

At the recent Becker’s Hospital Review Annual Meeting in Chicago, several presentations covered accountable care organizations, bundled payments and other new payment methodologies. Although not described specifically in these presentations, two different payment arrangements are emerging in which payers and providers are cooperating to reduce healthcare costs. This article compares and contrasts those payment methodologies.

"Cracking Health Costs" Reviewed

Over the recent weeks, numerous challenges have appeared to the “conventional wisdom” of healthcare reform.  Often touted as the solution to the growth in healthcare spending, accountable care organizations are now experiencing potential defections from the Pioneer ACO program, and

Risk Adjustment: How Physician-Patient Encounters Can Justify Themselves

A recent article on risk adjustment by a group of researchers from Dartmouth attracted our attention. Entitled Observational intensity bias associated with illness adjustment: cross sectional analysis of insurance claims , it describes biases that are found in various types of healthcare risk adjustment processes, with the bias is being caused by an increasing number of physician–patient encounters.

Can Accountable Care Succeed without Accountable Patients?

The movement towards accountable care is focused on making all providers "accountable" for the health status of their patients throughout the healthcare delivery system. Many of the guidelines for patient treatment revolve around physicians and other providers following "best practices", which have been established to provide the best combination of care and cost effectiveness for the overall population.

30 Day All-Cause Readmissions

Our friends at Strategic Business Alternatives have written an excellent series of articles about the opportunities and strategies for reducing 30-day readmissions.  In their three-part series on Medicare ACO Management: 30 Day All Cause Readmissions, they discuss the potential opportunity for cost savings, review several different models for addressing the problem, and some of the human and technological tools necessary to add

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