U.s. Department Of Health And Human Services

Many organizations have attempted to implement several different strategies to accomplish the goals of an ACO. A case study, performed by The Commonwealth Fund, proved Hill Physicians Medical Group to be rather successful in their plan to form an ACO. Hill Physicians collaborated with several hospitals and a commercial health plan (California Public

Accountability Care Organization (ACO) involves the organization developing an understanding for revitalizing for further success. Thus far, ACO’s have polarized by generally building platforms through collaborative efforts of utilizing management, quality, influencing cost, financing, and health service delivery. An important measure to an organization is identifying its competencies, strength, and weaknesses. An overview of this paper includes the importance of updating organization resources or technology so that it is proven through ACO’s to be a positive stream of revenue and a revolving door for more customers. However, ACO’s are aligned with making sure the organization objectives, workflow, financial goals, brand identity are being

The landscape of payment and organization in health care is changing again. As the federal government, states, and individual payers continue to migrate towards the ACOs, physicians and hospitals will face increasing pressures to change and adapt to new incentives surrounding cost and quality. As a hospital administrator, being able to adapt is a key to survival in an ever changing health care environment. I would definitely support explorative evaluation of our capacity to form an ACO and piloting a voluntary contract with Medicare and/or Medicaid.

Improvements in the efficiency and quality of care delivered by the U.S. health care system is largely dependent on reforming the way that care is supported, reimbursed, and delivered to patients. Hospitals and their constituents must plan for and ensure efficiencies in processes and practices while maintaining the highest quality of care. The Accountable Care Organization model, which Hallmark Health System follows, is an example of a delivery system reform that fosters greater coordination of care while concurrently aligning financial incentives to encourage organizations to deliver more efficient care. For example, a Lean process was initiated by the organization to identify methods to streamline workflow processes. This process views all

​Kaiser Health News recently published an article on a new trend in healthcare. This trend introduces the Accountable Care Organization (ACO). The Centers for Medicare and Medicaid services defines it as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients” (“Accountable Care Organization,” 2015). According to the Affordable Care Act (ACA), the goal of the ACO is to be able to share health cost-savings with providers who are able to save money by eliminating unnecessary procedures and reduce health costs while increasing quality of care. ACOs make health professionals become more accountable in maintaining good-quality, coordinated healthcare for a patient through a value-based system that is evaluated through a number of criteria and benchmarks (Ronai, 2011).

The white paper, “The Work Ahead: Activities and Costs to Develop an Accountable Care Organization”, prepared by Keith D. Moore and Dean C. Coddington for the American Hospital Association

The American health care system has been victim to an escalation in the prices of health care services juxtaposed with inefficiency in delivery of care services. There has even been cases where State spending on the actual health care increased dramatically in the United States and one of the key components of curbing this problem which has been prevalent over the mass media and has been a major discussion among physicians is the advent of Accountable Care Organizations. Accountable Care Organizations (ACOs) is structured with the goal of trying to improve health care delivery and aid in the reduction of the overall cost of services (Weissert & Weissert, 2012). If there is insufficient coordination of high quality care delivery in the health care industry, this will have a negative impact on patient safety and diminish affordable care for patients. Hence, the development of ACOs is envisioned to be the savior of medical practices and can improve the overall fabric of the American society (Bresnick, 2013). ACOs serves as one of the answers for curbing the problem of high costs, low quality care and possible segmented delivery and as much as it serve as the major determinant for improvement in patient satisfaction, there are minor

Advance Payment Account Care Organization Model which focuses additional support to physician owned and rural providers participating in the Medicare Shared Savings Program by providing start-up resources to build better infrastructures throughout. The shared savings which the Accountable Care Organization (ACO) would be split in half and given back to the organization which provided the savings. In other words, in the case of my hometown hospital, if an ACO would take over and re-open our hospital, the predictions are that by retrieving these savings which are provided for by Obama-care, and by right-sizing our hospital from a 45 bed hospital to a 10 bed hospital and right-sizing the amount of employees, we would be back in the black within a 2 year period. That is a major step in financing this hospital to continue servicing a major part of the community which needs major health care to continue.

The US Department of Health and Human Services (HHS) defines medically underserved area as ranking low on a scale that involves physicians per 1000 people, infant mortality rate, percentage below poverty level, and population >65 years old. 9 The HHS defines medically underserved population as that which includes “economic barriers (low income or Medicaid-eligible populations or cultural/linguistic access barriers to primary medical care services.” 9 According to the American Pharmacist Association, approximately 85% of US states have 61-100% of counties with medically underserved areas. 11 “28% of poor, 23% of near poor…[lack] health insurance coverage,” which is much higher than the national percentage of 13%.6 When reviewing the risk factors for vaginitis such as lack of health insurance, tobacco use, lack of bachelors degree, Hispanic origin, etc., many of the women suffering from the condition fall under the category of the underserved population as defined above. This means that clinics with the purpose of treating underserved areas and populations must have a heightened awareness of the prevalence and significance of vaginitis and must be interested in staying up to date on the most efficient medical practice strategies given the patient population.

When faced with the reality of the Affordable Care Act (ACA) becoming law and taking effect, Jim began to implement new rules and guidelines. Although impravision a strategic plan the institution is expected to follow as supplies and resources would soon be in critical demand. As CEO, he understood what was expected of the health care system, focusing mainly on the organizational needs that will help with the expanding or the growing populationu8, meeting the increased demand for the future. Via industrialized existing programs and building clinics that will accommodate the expected significant impact of the newly insured. “Eliminating ED crowding will take the collective involvement of healthcare workers, business leaders, politicians, the press, and the public” (Derlet & Richards, 2008). After much consideration, and a comprehensive evaluation of the documents for the new Affordable Care Act, Jim James, CEO thought about the upcoming opportunities using a persuasive approach to transform the hospital. Since he stated that his most pressing desire is to find ways to connect the recipients in a way that will model changes in existing programs. Admittinly, we have a medical (that is, sick) care system- a system that waits until we become ill before it kicks into action instead of a healthcare system focused on helping us stay healthy (Schimpff, 2012). The justification, seeing the possibilities that crucial in dealing with changes in the upcoming health care system using a

There has been discussion to have universal healthcare system similar to Medicare as a method to have a centralized monitoring system of cost. There have also been other systems tried beginning with HMOs in the 1970s in an effort to streamline access to necessary healthcare services by employing a gatekeeper to their access at the primary care levels. With patient dissatisfaction, PPOs were tried which circumvent the necessity of referrals (Hacker, 1998). Either of these models had substantial effect on healthcare outcomes while the cost of healthcare continued to skyrocket. The US spends more than any other country on healthcare but outcomes are not better (Blackstone, 2016). In 2010, under President Obama’s leadership, Affordable Care Act was passed and one of the promising features is the formation of accountable care

The Accountable Care Organization (ACO) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients (McCarty, B., 2016). For example, Medicare Shared Savings Program was created by The Center for Medicare & Medicaid Services to monitor and establish that all ACO’s are meeting the quality performance benchmarks and reduce Medicare spending by certain percentages (H., 2017). The growth of ACO’s from 2011 to 2016 is astonishing, in 2011 there was 64 ACO’s and by 2016 they have risen to 838 in the U.S. (H., 2017).

The envisaged benefits that ACO intends to deliver have made the ACO model to capture the industry attention nationwide. However, many hospitals are still considering their current state of readiness for ACO. On the other hand, some healthcare organizations are moving towards taking early steps of meeting the laid down requirements of CMS's (Centers for Medicare and Medicaid Service's). While ACO model is still a work-in-progress, the goal of the

Texans are being short changed by the proposed Medicaid cuts. Legislature has told the Texas Health and Human Services Commission (HHSC) that they must cut $350 million from the Medicaid funding over the next two years. In order to abide by the legislature’s demands, the HHSC has proposed cutting the reimbursement rates for pediatric physical and occupational therapists on average by 10 to 25 percent. And pediatric speech therapists would face cuts of 16 to 27 percent. Many feel that these cuts to the therapy payments have little to no effect on the services that children with disabilities receive. These individuals say that following the orders will assist in reducing the therapy rates and will reduce the practice of excess therapy. On the opposing side, it has been expressed that cutting therapy funds that the State of Texas provides has the potential to cause individuals within the pediatric population to lose crucial therapy services. The planned cuts have the risk to jeopardize the potential of our nation’s young. The cuts also make many agency’s that currently provide occupational, physical and speech therapy vulnerable to closures and lay-offs.

Accountable Care Organizations (ACOs) came into being in 2010 after the passage of the Affordable Care Act (ACA) also known as Obamacare (Mayberry 2016). ACOs today in the United States number about seven hundred, with over twenty million customers (Scheffler, 2015, p. 640). The twenty million customers, consists of customers covered by Medicare and private insurance contracts (Muhlestein, 2015, as cited in Scheffler, 2015). ACOs were created to improve healthcare, by delivering efficient healthcare services at lower cost. “The goal of ACOs, which consists of physicians, and hospitals, is to improve the quality of health, health outcomes, and health care spending among its attributed groups” (Mayberry, 2017, p. S61). Each ACO is required