Indeed, pursuit of the ACO model is a keystone of the Affordable Care Act.
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If the ACO reduces costs while improving quality, the providers keep some of the savings.
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Patients can even decide not to share their claims data or medical history with the ACO.
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Sam VanNorman from Park Nicollet outlined what they have learned as a Pioneer ACO.
If the providers in the ACO achieve better outcomes, they divvy up money saved with the health plans.
The architects of the ACO initiative somehow assume that making the existing system more efficient will make health-care affordable.
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In Chicago, the large Catholic hospital system Presence Health is incorporating end-of-life care and advanced-directives into its ACO.
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The Everett Clinic in Washington state has taken steps to plug this hole by deciding not to become a full-fledged ACO.
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The most prominent new model is the Accountable Care Organization (ACO).
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While there are several proposed bundled payment types, including retrospective and prospective types, the onus of financial responsibility is shifting to the ACO.
If an ACO meets goals for the quality of its care and pushes costs below a set level, it may receive a bonus.
By working together, ACO participants help reduce the number of duplicate procedures and services that patients receive, reducing the overall cost of medical care.
The seems to be unfair both to the responsible ACO provider and to the patient, who will likely not receive optimal care in these transitions.
WSJ: Christensen, Flier and Vijayaraghavan:The Coming Failure of 'Accountable Care'
And Oliver Wyman consultants say their figures in their analyst are based on the latest ACO figures from the U.S. Department of Health and Human Services.
The JCOI, created in 2010, grew from conversations between George Lewis (then head of Columbia University's Center for Jazz Studies) and Michael Geller, the ACO's executive director.
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At last count, one in two Americans had access to medical care provided through an ACO, according to Oliver Wyman research, including 4 million seniors covered by Medicare.
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Well, not all members of an ACO are publicly traded companies, making it hard for investors looking to take advantage of improvements in healthcare technology, processes and coordination.
The point of the ACO is to create a scenario where a group of physicians, hospitals and other health care workers can work closely together in the care of a patient.
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Both are radical departures from fee-for-service medicine in that medical care providers are banding together through their practice, clinic or a business umbrella like an ACO to manage populations of patients.
The providers in an ACO are responsible for managing the care of the health plan enrollees and are financially rewarded if the enrollees, or patients, stay out of the more expensive hospital.
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Accountable Care Organizations (ACO): ACOs will launch in January 2012 and allow physician organizations and health systems to earn a significant share of any savings generated by more efficient healthcare delivery.
It is possible that, based on the large number of participants that will be a part of a given ACO, the ACO may assume the risk of coverage for individuals and employees of small business.
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The ACO takes responsibility for keeping the patients out of the hospital and emergency room and helps patients manage their conditions by getting them to take their medications appropriately and coming back for needed appointments.
An ACO would want to securitize the EOC because it can exchange future cash flows for money now, possibly using that money to modernize systems and management techniques in order to increase profits from other EOCs.
Thus, we could be heading toward a system where large corporations continue to self-insure while requiring their employees enroll in an ACO while everyone else is on a government plan that requires patient membership in an ACO.
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Whether it is through an accountable care organization (ACO) or bundled payment to a patient-centered medical home, insurance companies and government health programs like Medicare are moving toward so-called value-based payment systems and away from fee-for-service medicine.
Investors may push for efficiency, either directly by pushing ACO managers to provide more cost-effective care, or indirectly, by passing on the purchase of EOC-ABSs if the originating ACO has a history of high costs relative to profits.
There was a let off for Scotland when Aco Stojkov gathered a cute Pandev pass to burst into the penalty area but the midfielder elected to cut the ball back rather than shoot from a promising position, allowing the defence to clear.
If a woman from, say, Massachusetts, spends half the year in Florida and receives care there, the Massachusetts ACO is still responsible for managing the patient's medical costs, though it in no way was able to manage the Florida care.
WSJ: Christensen, Flier and Vijayaraghavan:The Coming Failure of 'Accountable Care'
For example, an ACO could bundle a certain episode of care (EOC), such as the services required to manage a patient receiving a heart transplant, and then create a financial instrument based on profits associated with providing that particular set of care.
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