How to make successful Accountable Care Organization?

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How to make successful Accountable Care
Organization?
Value-based care is gaining more popularity in
the US healthcare system and Accountable care
organizations (ACOs) provide the main push for
the healthcare industry away from fee-for-service
towards value-based care. ACO is a very
interesting model for care where groups of
doctors, hospitals, and other health care
providers voluntarily offer coordinated,
high-quality care to patients. The organizations
achieve their goals with the help of a universal
budgeting system and value-based
reimbursement. Moreover, through care
coordination and a shared savings payment model,
ACOs strive to improve patient outcomes and
population health management while keeping costs
to a minimum. You can find many ACO models and
there is no standard ACO model. For
Example- Some ACOs include specialists and
hospitals while others focus solely on
strengthening primary care services. However,
each model has a nuanced funding structure and
value metrics they report on, and contracts vary
from group to group.
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How to make successful Accountable Care
Organization?
Moreover, clinically integrated networks (CINs)
and ACOs are interchangeable because ACOs are
moving away from a legal partnership and towards
care coordination. All ACOs have only one goal
i.e. deliver high-quality care for lower costs
and many ACOs are following common strategies for
earning shared savings payments and other
value-based incentives while delivering
high-value patient care despite their
differences. Strategies for successful
accountable care organization Reducing
out-migration from your ACO network You should
pay yourself first for the provided care than a
competitor. It is impossible to provide
everything to your healthcare consumers but make
every effort to reduce the leakage of services
you can perform. For example, establishing or
increasing after-hours care can help to reduce ED
visits. You can find new opportunities for new
lines of business by understanding higher costs
outside your network or the establishment of new
contractual relationships. Providing cost and
quality transparency to providers in your ACO
will help them make the best decisions for
patient care.
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How to make successful Accountable Care
Organization?
Building care teams You need to expand your care
teams once you expand available services for more
coordinated care and sometimes you need several
roles that are not necessarily revenue-generating.
For example- An administrator or care
coordinator often does not produce billable hours
or services that the ACO can create a claim for.
However, these team members can enhance the
patient experience that can have long-term
impacts on patient outcomes.   Moreover, ACOs
must make the challenging decision to improve
care coordination by growing these non-revenue
generating positions and today shared savings
payments can help to support new care team
members and the coordinated services they provide
to patients. This care coordination drives
patients appointments, instills confidence in
their treatment options, and builds trust with
their providers. As a result, ACO will be a
preferred choice for the patient rather than the
emergency department.
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How to make successful Accountable Care
Organization?
Use data to inform decision It is observed that
still today, many healthcare organizations rely
on spreadsheets and paper reports to translate
data into actionable insights, but these tools
are overwhelming and difficult to interpret hence
many ACOs are investing in point-of-care
dashboards. These dashboards provide insights on
key quality metrics with the help of EHR
integration. Providers opening the EHR during an
annual wellness visit can immediately see which
gaps in the care they should focus on closing for
patients based on the ACOs standard of care. The
specific metrics highlighted in the dashboard are
largely the result of the ACO agreement between
payers and providers. Moreover, the dashboard
can provide quality measures that are required
for payment because they are linked to payment.
Moreover, ACOs can add other measures to the
dashboard based on their specific patient
populations needs. Participating in an ACO does
require significant investments but these
strategies are helpful to make a successful
accountable care organization. If you are looking
for any help in medical billing services, then
you can get in touch with us.