Posts Tagged ‘Accountable Care Organizations’

HINfographic: Measuring Accountable Care Success

July 31st, 2017 by Melanie Matthews

What are the hallmarks of a flourishing accountable care organization (ACO)? Robust clinical outcomes and satisfied patients, say respondents to the 2017 ACO Survey by the Healthcare Intelligence Network. Adoption of ACOs more than doubled in the last four years, and ACO leadership shifted from physician-hospital organizations to integrated delivery systems.

A new infographic by HIN examines what other measures healthcare organizations use to measure ACO success, ACO physician staff size and ACO administration trends.

The accountable care organization, or ACO, has become a cornerstone of healthcare delivery system and payment reform by raising the bar on healthcare quality and reducing unnecessary costs. There are now more than 700 ACOs in existence today, by a 2017 SK&A estimate.

2017 Healthcare Benchmarks: Accountable Care Organizations, HIN’s fourth compendium of metrics on ACOs, captures ACO operation in today’s value- and quality-focused healthcare environment. This 50-page report, now in its fourth edition, delivers actionable data from healthcare companies who completed HIN’s fourth comprehensive ACO assessment in May 2017.

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Infographic: Anatomy of the ACO Market

May 31st, 2017 by Melanie Matthews

Since the first accountable care organization (ACO) came to market in 2010, the size and shape of the market has changed drastically, according to a new infographic by Oliver Wyman.

There are now 630+ ACOs in the market, plus hundreds of additional pilots being tested. The infographic presents a comprehensive analysis of the ACO market. From overall size of the market to regional differences, “winners” by type, and trends in risk-based models.

The accountable care organization, or ACO, has become a cornerstone of healthcare delivery system and payment reform by raising the bar on healthcare quality and reducing unnecessary costs. There are now more than 700 ACOs in existence today, by a 2017 SK&A estimate.

2017 Healthcare Benchmarks: Accountable Care Organizations, HIN’s fifth compendium of metrics on ACOs, captures ACO operation in today’s value- and quality-focused healthcare environment.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: Top Accountable Care Organizations

March 24th, 2017 by Melanie Matthews

There are over 700 accountable care organizations (ACOs) across the country, according to a new infographic by SK&A, with California leading the way with the most ACOs.

The infographic examines each state’s ACO ranking by the number of ACOs as well as the top five ACOs by the total number of participating physicians.

Care Coordination in an ACO: Population Health Management from Wellness to End-of-LifeWhen acknowledging its position as a top-ranking Medicare Shared Savings Program (MSSP), Memorial Hermann is quick to credit its own physicians—who in 2007 lobbied for a clinically integrated network that formed the foundation of the current Memorial Hermann accountable care organization (ACO). Now, eight years later, collaboration and integration continue to be the engines driving the ACO’s cost savings, reduced utilization and healthy patient engagement rates associated with Memorial Hermann ACO’s highest-risk population.

Care Coordination in an ACO: Population Health Management from Wellness to End-of-Life details Memorial Hermann’s carefully executed journey to quality and the culmination of the ACO’s community-based care management program.

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Infographic: ACO Trends

January 23rd, 2017 by Melanie Matthews

Momentum in value-based care has been building over the last several years, and 2016 was no exception, according to a new infographic by Oliver Wyman.

The infographic maps out the more than 630 ACOs in the United States.

Care Coordination in an ACO: Population Health Management from Wellness to End-of-LifeWhen acknowledging its position as a top-ranking Medicare Shared Savings Program (MSSP), Memorial Hermann is quick to credit its own physicians—who in 2007 lobbied for a clinically integrated network that formed the foundation of the current Memorial Hermann accountable care organization (ACO). Now, eight years later, collaboration and integration continue to be the engines driving the ACO’s cost savings, reduced utilization and healthy patient engagement rates associated with Memorial Hermann ACO’s highest-risk population.

Care Coordination in an ACO: Population Health Management from Wellness to End-of-Life details Memorial Hermann’s carefully executed journey to quality and the culmination of the ACO’s community-based care management program.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today. Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: Delineating Accountable Care Responsibilities

May 25th, 2016 by Melanie Matthews

States introducing accountable care organization (ACO) programs into an existing Medicaid managed care environment will need to assign responsibilities between ACOs and managed care organizations (MCOs). Successful delineation of responsibilities can support ACOs and MCOs in complementing one another and being better positioned to improve care delivery for Medicaid enrollees, according to a new infographic by the Center for Health Care Strategies Inc.

The infographic identifies five responsibilities that both ACOs and MCOs may share and outlines which entity may be better suited to perform each function.

2015 Healthcare Benchmarks: Accountable Care Organizations Even before CMS published its agenda for moving Medicare into value-based payment models like the accountable care organization (ACO), the number of public and private ACOs had exceeded 700, by a Leavitt Partners estimate. Already, more than 20 percent of healthcare organizations plan to participate in Medicare’s latest accountable care model, the Next Generation ACO, in the coming year.

Support for CMS’s latest alternative payment offering is just one of the ACO metrics contained in 2015 Healthcare Benchmarks: Accountable Care Organizations. HIN’s fourth annual compendium of metrics on ACOs captures how ACOs are faring in an industry rapidly shifting away from fee for service to one that rewards quality, the patient and population experiences, and cost efficiencies. Click here for more information.

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5 Ideas to Improve ACO Performance Results

June 19th, 2014 by Cheryl Miller

One step John C. Lincoln network took to improve performance results at the end of its first year as a Medicare Shared Savings Program accountable care organization (MSSP ACO) was to focus on a relatively small number of patients, the top 5 percent of beneficiaries by claims volume who actually account for about 60 percent of medical spend, explains Heather Jelonek, CEO for ACOs at John C. Lincoln Network, who shares additional strategies here.

First, we decided to institute wellness visits across our health system. We’ve worked with several large third party payors here in the valley where they’re now recognizing the Medicare G-codes for wellness visits. We bring those patients in and get a full survey of what’s been going on with them.

Second, we’re engaging in regular population management. We now have our physicians talking about how often they want to see their patients with diabetes or hypertension or cancer.

Third, we’re also starting to focus on those individuals who are ‘aging in;’ those patients who are about 62½. We’re trying to get them in and get them into a routine, making sure they’ve got A1C scores every quarter and every six months, and have had their flu shots and colonoscopies. We’re hoping a healthier generation of individuals coming into the Medicare program improves the quality outcomes that we’ll see long-term.

Fourth, we’ve developed a standardization for our quality reporting. We’ve looked at the top 5 percent of our beneficiaries by claims volume, who actually account for about 60 percent of our medical spend. We’re hoping that by focusing on a relatively small number of patients, we’ll have a drastic impact on outcomes.

Next, we’re also leveraging our electronic medical record (EMR) to the fullest extent; we’re participating in a number of conversations and baseline studies with EPIC®. They are very interested in seeing what we’ve done with the tool and how we’re making it usable for our ACO reporting.

But the one thing that we will continue to struggle with and continue to dive deeply into is integration opportunities: talking to other communities, looking at health information exchanges (HIE’s) as we’re acquiring a new practice or signing a new community physician onto our ACO — bringing everybody to the table so that we’re all speaking the same language.

Excerpted from Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care.

3 ACO Opportunities to Improve Patient Engagement

April 17th, 2014 by Cheryl Miller

Patients are 30 percent more likely to enroll in care management during or immediately after an acute event if they are contacted directly and introduced to a program and services, as opposed to being contacted via telephonic outreach, says Colin LeClair, executive director of ACO for Monarch HealthCare, which was a top performer in year one of the CMS Pioneer ACO program.

Through trial and error we found three opportunities to identify opportunities to yield patient engagement. First, getting the principal caregivers’ endorsement or that of the physician staff was by far the most effective means of earning the patients’ trust and getting them actively engaged. If we can say to a patient that ‘your physician has asked us to speak to you’, we get a ‘yes’ from the patient 80 to 90 percent of the time.

The second most effective means of enrolling patients in our care management program is during or immediately after an acute event. The idea is to catch them in the hospital if you can — immediately after they are admitted — and introduce them to the accountable care organization (ACO), our services, and what we can do to help them stay out of the hospital in the future. We found that patients are 30 percent more likely to enroll in care management during or immediately after an acute event, versus the cold telephonic outreach alternative. But this approach requires partnerships with hospitalists or with other hospital staff to notify you of those admissions because we don’t receive those from care management services in real-time data.

And finally, we find that patients are also somewhat receptive to care management services following a new diagnosis and we’re looking for those markers in the claims data as we receive it.

Excerpted from Tactics from a Top-Performing Pioneer ACO: Engaging Patients and Providers in Accountable Care.

Physician Group ACOs Value Specialists, Nurse Practitioners

March 19th, 2014 by Jessica Fornarotto

As the number of public and private accountable care organizations nears 500, participants are fine-tuning the ACO model. In the few years since the ACO model entered healthcare’s consciousness, administration has shifted from hospital-led to physician-only leadership to PHO-helmed ACOs. In its third annual industry survey on ACOs, conducted in 2013, the Healthcare Intelligence Network captured how 138 healthcare organizations are participating in ACOs.

Drilling down to the multi-specialty physician group perspective, this survey analyzed the number of existing ACOs for this sector, which providers participate in the ACO, and more.

With their built-in cadre of healthcare providers, multi-specialty physician groups (referred to here as physician groups), which comprised about a tenth of survey respondents, would seem ideally placed to transition to accountable care organizations. Percentage-wise, this sector has the highest rate of existing ACOs (57 percent participating in ACOs versus 34 percent of overall respondents) and twice the rate of participants in the CMS Pioneer ACO program (25 percent versus 13 percent).

In other deviations from the norm, twice the number of physician group-reported ACOs favor the hybrid FFS + care coordination + shared savings payment model (75 percent of physician-group ACOs versus 37 percent of overall respondents).

More than half of ACOs in this sector are administered by independent physician associations (IPAs), and most are smaller than the hospital-sized ACOs reported in the survey, with three-quarters reporting a physician staff of less than 100. These ACOs benefit from having specialists on board in greater numbers to help with care coordination of the chronically ill (100 percent include specialists, versus 71 percent overall).

They also unanimously include nurse practitioners (versus 90 percent of overall respondents) and with 50 percent including clinical psychologists in the ACO (versus 42 percent overall), are a little further along on the path of integrating behavioral health into the accountable care initiative.

Cognizant of the full care continuum, these IPA-led ACOs are almost twice as likely as overall respondents to include skilled nursing facilities (50 percent versus 29 percent overall) and hospice (75 percent versus 42 percent overall) in their ACOs.

Excerpted from: 2013 Healthcare Benchmarks: Accountable Care Organizations

Healthcare Business Week in Review: Health Insurance Exchanges, Navigators, Medication Adherence

August 30th, 2013 by Cheryl Miller

Contrary to popular opinion, young adults between the ages of 19 and 26 do not think they’re immortal and do think they need health insurance. In fact, according to a study from The Commonwealth Fund, if members of this population don’t have health insurance, it’s because they can’t afford it.

Nearly half of the 15 million young adults enrolled in a parent’s health plan last year most likely would not have been eligible for coverage without the health reform law’s dependent coverage provision.

The survey also found that only 27 percent of young adults were aware of the state health insurance marketplaces launching October 1. The demographic that would benefit most from these marketplaces are those without coverage and those from low- or middle-income households, or, those least likely to be aware of them.

But these young adults, and all other adults, can seek out help through a coterie of navigators funded by the HHS. The agency has granted $67 million to 105 applicants in federally run and state partnership marketplaces, for navigators trained to help Americans who need assistance in shopping for and enrolling in plans in the health insurance marketplaces beginning this fall.

Health information navigators are trained to provide unbiased information in a culturally competent manner to consumers about health insurance, the new HIEs, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program (CHIP). Funding was available to eligible private and public groups and the self-employed who met certain standards to promote effectiveness, diversity, and program integrity, HHS officials say.

If all the health reform changes have made Americans’ blood pressure soar, there is help: a large scale study from Kaiser Permanente found that single pill combinations and consistent follow-ups with hypertension patients helped improve the rate of blood pressure control by nearly twice as much. Through one of the largest community-based hypertension programs in the nation, Kaiser Permanente Northern California nearly doubled the rate of blood pressure control among adult members with diagnosed hypertension between 2001 and 2009, helping to reduce the risk of stroke and heart attack for patients.

And speaking of soaring, accountable care organizations are flooding the healthcare landscape; with the number of public and private ACOs nearing 500, participants and pundits alike are looking more closely at the model’s structure, challenges and benefits.

How is your organization participating in ACOs? Take HIN’s third annual survey on ACOs by September 6, 2013 and receive a FREE executive summary of the compiled results.

Infographic: ACOs’ and PCMHs’ Tools for Success

June 21st, 2013 by Melanie Matthews

The primary motivator for becoming an ACO or PCMH is to improve patient outcomes (66%). That consideration is seconded by two separate motivators: being able to better utilize resources across the health care system (41%) and maintaining market share (40%), according to a new study by eClinicalWorks.

eClinicalWorks has released an infographic on the study results, highlighting the biggest challenges for ACOs, along with the most valuable tools in an ACO.

ACOs and PCMHs Tools for Success

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You may also be interested in this related resource: Guide to ACOs.