The Healthcare Executive's Guide to ACO Strategy
The Healthcare Executive's Guide to ACO Strategy is the first comprehensive book dissecting the integral components of ACOs from physician, provider, and payer views, including analysis of the CMS final regulations.
In the wake of healthcare reform, ACOs continue to emerge as the care delivery and reimbursement model of the future. Get the book that provides specifics on incorporating accountable care structure and strategy into your organization so you can enter the ACO era prepared and positioned to succeed.
Get expert advice on ACOs and the elements for success, including how to:
- Participate in the CMS Shared Savings program
- Distinguish the various characteristics of an ACO and its operations
- Understand how ACO reimbursement structure will work
- Evaluate the process of forming an ACO-including the legal, financial, IT, and governance requirements
- Fulfill important quality measures for an ACO
- Reshape and refine hospital-physician alignment strategies
Table of contents:
Chapter 1: ACCOUNTABLE CARE ORGANIZATION OVERVIEW
- What Is an ACO?
- The Logic of ACOs
- Basic ACO Tenets
- Key Characteristics of Accountable Care
Chapter 2: HOW WE GOT HERE
- A Look Back at the 1980s and '90s
- The Alternatives to HMOs
- Medicare Prospective Payment System
- Physician-hospital Organizations
Chapter 3: WHAT WE ANTCIPATE ABOUT THE ACCOUNTABLE CARE CONCEPT
- Accountable Care Organizations
- Why ACOs?
- What Will an ACO Look Like?
- Structural Change
- Challenges of Collaboration
Chapter 4: PHYSICIAN-HOSPITAL INTEGRATION
- ACOs as a Driver of Alignment
- Different Alignment Models
- Continuum of Care and Integration
Chapter 5: COMPENSATION AND ANTICIPATED CHANGES
- Historical and Current Reimbursement Structures
- Proposed Reimbursement Structures
- Medical Home Payment Models
Chapter 6: ARE YOU READY FOR AN ACO ENVIRONMENT?
- Organizational Assessment
- Financing: Startup and Ongoing Expenses
- Market Assessment
Chapter 7: LEGAL CONSIDERATIONS
- Antitrust Issues
- Stark Law and Anti-kickback Statute
Chapter 8: THE CMS SHARED SAVINGS PROGRAM
- Program Overview
- Shared Savings Program Tracts
- Interim Payment Option
Chapter 9: BENCHMARKS FOR SHARED SAVINGS PROGRAM
- Assignment of Beneficiaries
- Cost Benchmarks
- Review of the Norton Healthcare and Dartmouth-Hitchcock Health Care System ACOs
Chapter 10: QUALITY MEASURES
- Benchmarks, Standardization, and Protocols
- Utilization of Evidence-based Medicine
- Measuring Outcomes
- Patient Compliance
Chapter 11: THE ROLE OF INFORMATION TECHNOLOGY
- Technology Considerations
- Health IT Market as it Relates to ACOs
- Harmonizing the ACO through Connectivity
Chapter 12: PATIENT-CENTERED MEDICAL HOMES
- How Consolidation Has Shaped the Future
- Positioning for an Evolving Healthcare System
- What is the Patient-Centered Medical Home?
- Comparing ACOs and Medical Homes
Chapter 13: Where Do We Go From Here?
- Form Physicians-Hospital Alliances
- Partner in the Delivery of Quality and Cost-effective Medical Care
- Review Current Compensation and Reimbursement Models
- Recap of ACO Programs
Meet the author:
Coker Group, is a leading management consulting firm specializing in strategic solutions for businesses within the healthcare industry. Their expertise in strategy, finance, and technology problem solving is unparalleled. For more than 20 years, they have brought their clients the best in service, support, and results.
Max Reiboldt, CPA, is president and CEO of Coker Group. His expertise encompasses employee and physician employment and compensation, physician-hospital affiliation initiatives, business and strategic planning, mergers and acquisitions, practice operational assessments, ancillary services development, PHO/IPA/MSO development, practice appraisals, and negotiations for acquisitions and sales.
Published: April 2012