Summary: The Accountable Care Organization
The Accountable Care Organization (ACO) is the most aggressive organization in place to improve health care services and financially rewards their ACO members. The Accountable Care Organization has major emerging opportunities for cost reduction in health services. The ACO is continuously searching for methods to diminish the cost of medicinal services. Providing high quality care with a lower cost can increase their member’s quality of life and reduce the probability of their members utilizing health services. ACOs are working towards cutting health care expenses and increasing the quality of patient care in most organizations. The Accountable Care Organization members reward the physician and health care facility when their performance meets
Medicare Shared Savings Case Study
144 Words | 1 PagesMedicare Shared Savings Program provides and incentive to ACO participants that are capable of lowering growth in Medicare health care costs in addition to meeting performance standards for quality of care and putting patients first. It was not until October 20, 2011 the Center for Medicaid and Medicare Services (CMS) released the final details regarding the ACO that specified the Shared Savings program authorized by ACA. The purpose of the program should improve access to capital precisely targeting those smaller ACO entities which are physician owned and/or located in rural locations. CMS will not pursue recoupment of any advanced payments not repaid from shared earnings, if the ACO completes the full three-year contract term and decides
External Factors For The Memorial Herman Health Care Organization
571 Words | 3 PagesBy accommodating to these changes the organization to better serve a greater population at a greater level of quality. Laws and policies also have impacted the organization, such as the Affordable Care Act (ACA). The ACA allowed more patients to have access of healthcare services, driving the demand for health care services higher. This called for the need to increase supplies and staff for the organization. With the ever-changing technology updates, the organization must keep up to date to provide the best quality of care available which can cost an organization extra time and
Physician Quality Reporting System (PQRS)
565 Words | 3 PagesSince CMS implemented the Physician Quality Reporting Initiative (now known as the Physician Quality Reporting System (PQRS) under the Tax Relief and Health Care Act of 2006 (TRHCA), there have been several changes in participation sanctions, reporting mechanisms and eligibility for incentives and bonuses. During the first two years, the program was technically a temporary, renewable initiative that sought to improve the quality of both delivery and coordination of care. The initiative became permanent when the Medicare Improvement for Patients and Providers Act (MIPPA, 2008) was enacted. The Centers for Medicare and Medicaid Services (CMS) believes the sanction-based initiative will empower consumers and providers to make better informed decisions
What Is The Difference Between Cigna HMO And Heritage California ACO?
582 Words | 3 PagesCompare and Contrast CIGNA HMO and Heritage California ACO from the lens of the consumer Introduction In the US, there are many health insurance plans designed to meet different individual needs with various advantages and disadvantages of their own. This research paper, focuses on the two different health plan models those are Cigna HMO and Heritage California ACO. Health Maintenance organization (HMO) is basically a type of health plan that limits the freedom of choice of the provider, as the coverage is given to patients who take care from the physicians who contact with the HMO and its main focus is on the prevention and wellness (Wedig, 2013). ACO health plans basically focuses on the care coordination, promote prevention and wellness,
The Joint Commission's Report To The Carnegie Foundation
1349 Words | 6 PagesTheir mission is “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value”, (Joint Commission, 2014). The accreditation from the Joint Commission can be earned by multiple health care organizations including critical access hospitals, office based surgery centers, behavioral health care facilities, and home care services. For a hospital setting, the Joint Commission places the performance measures into accountability and non-accountability measures. They look at research and if the facility is performing evidence-based care process which improves health outcomes, proximity which the care process is linked to the patient outcomes, accuracy for whether or not the care process has indeed been provided, and any adverse effects. To earn and maintain The Joint Commission’s Gold Seal of Approval™, an organization must undergo an on-site survey by a Joint Commission survey team at least every three years (Joint Commission,
Affordable Care Act Case Study
535 Words | 3 PagesHHS expects 90% of Medicare payments to be directly tied to quality measures by 2018. It is imperative that hospitals, urgent care clinics and frontline providers align their
Healthcare Reform 101 Summary
588 Words | 3 PagesFurthermore, there should be a more reasonable distribution of cost amongst Americans, with younger and healthier Americans assuming some of the financial burden for those less healthy. Another goal of the ACA is to stabilize the skyrocketing cost of health care. One way to stabilize cost can be accomplished by reforming the way payment and reimbursement of services occurs—outcomes versus volume. A final goal of the Affordable Care Act is to provide incentives that reward wellness and preventative medicine (Panning,
2016 Health Care Compliance Report
622 Words | 3 PagesHealth Care Compliance in 2016 It's difficult to imagine that we've nearly closed the books on 2015. However, before we can really say goodbye to this year and begin focusing on what is to come in the future, we must first prepare for the changes that will take place in 2016 due to the Health Care Reform Act. While much of the ACA is already in place, there are still several portions that have yet to take effect.
Affordable Care Benefits
633 Words | 3 PagesExamples include programs to reduce unnecessary hospital readmissions by coordinating care and services for patients when they leave the hospital. Other provisions provide for the development of Accountable Care Organizations, bundled payments, and medical homes all of which are intended to provider higher-quality, coordinated care for beneficiaries. The Affordable Care Act also covers seniors on preventative services and annual wellness visits. Medicare beneficiaries are eligible to receive many preventive services with no out-of-pocket costs. These include flu shots, tobacco cessation counseling, as well as no-cost screenings for cancer, diabetes, and other chronic diseases.
Advantages And Disadvantages Of Clinical Integration In The Strategic Planning Process
1249 Words | 5 PagesPhysicians and Hospitals go hand in hand when it comes to the medical care of patients, and it is this relationship that allows the patients to receive the care they need and deserve. It is also this relationship that we as health care administrators need to understand. In order to fully understand this relationship we need to define the concept of the integrated physician model. We also need to explain the importance of clinical integration in the strategic planning process, and the dynamics of and controversies surrounding accountable care organizations and alternative approaches to the current health system. I will also explain the advantages and disadvantages for hospitals and physician’s models.
Blue Ridge Paper Products And Medical Tourism: A Case Study
1200 Words | 5 PagesBy partnering together and forming their own Accountable Care Organizations (ACOs), they are hoping to drive down costs for Boeing by excluding the insurance companies, essentially removing the middle man (Stiffler, 2014). The physicians and hospitals are rewarded for keeping their employees healthy and benefits to their employees include less paycheck deductions, higher Health Savings Account contributions, a reduction in co-payments, and complete coverage for generic drugs (Stiffler, 2014). Eventually, these types of partnerships may then allow hospitals to
Value Based Healthcare Marketing Strategy
1551 Words | 7 PagesAs the healthcare landscape continues to shift, medical providers and hospitals are continuously being challenged to develop clear and concise visions and redesign care delivery in ways that will usher proper transitions to value-based care. As value-based healthcare continues to take root, more and more hospitals and providers are finding themselves with little option but to join the movement. However, the jump from previously utilized fee-for-service models to value-based healthcare is not an easy one, and many healthcare organizations are finding it difficult to do so. The greatest challenge lies in successfully making the transition from volume to value-based healthcare in ways that are financially stable. Such inherent difficulties faced by those within the healthcare system are what have necessitated strategic
Health Care Stakeholders Analysis
1010 Words | 5 PagesA patient is going to have a different idea of how a health care should be managed. This in contrast to the way a physician may think the administration should be managed. Furthermore, each different stakeholder involved would have their own ideal reasons to why the health care administration
Importance Of Accountability In Healthcare
1090 Words | 5 PagesThe importance of accountability in the health care industry Accountability
Endo-Tech LLC Case Study
1360 Words | 6 PagesIn the words of Froeb, McCann, Shor, and Ward, in order to create incentives an organization must first have ways of measuring both behavior and overall performance (Froeb et. al., 2016). Thus, in order for the accountability piece to happen, a performance metric or an employee evaluation rubric is what should serve as a guide for both managers and staff. This instrument of evaluation should be utilized as a model where both the evaluator and person being evaluated collaborate to thoroughly analyze their performance and to develop a plan to either continue reinforcing the positive qualities and attributes or to devise a system for improvement. The emphasis of this evaluation model is to establish an open line of communication between managers and staff and to help gather data that can be instrumental in any management design changes that could be made in the future.
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