Tag Archives: ACO

Not perfect, but practice makes progress for ACOs

Recently released results of the Medicare Shared Savings Program (MSSP) highlight the fact that Accountable Care Organizations need to be in it for the long haul. In August, the Centers for Medicare & Medicaid Services issued an update announcing that participating ACOs continue to show improvements in their ability to contain costs. Three hundred and […]
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Health care industry changes mean there’s always something new to learn

There are only so many hours in the day and your current deadlines and duties likely take up most of them. But if you don’t take time to make plans to adjust to the changing health care industry, you could be left behind. You can learn to set your optimal pace for change and determine […]
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Addressing the possible effects of overlapping reimbursement models

At the core of bundled payments is the goal of improving coordination between all of the facilities and agencies a patient might visit or employ during one episode of care. But as health care providers adjust to this new reimbursement model, some are experiencing trouble coordinating bundled payments with other value-based care initiatives. In the […]
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Understanding the risks of incomplete medical coding

Information that could affect readmission risks, reimbursement, quality assessments and more is missing from medical records according to a recent study. MedPageToday reported on the study, conducted by researchers at Johns Hopkins University School of Medicine and published in November 2015 in the journal PLOS ONE. The researchers compared two large databases – one based on claims […]
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Health systems: Do you see payers as partners or adversaries?

“It’s not the fact that we did that, it’s how we did it.” That’s what Jeff James, chief executive officer for Wilmington Health says is the headline from his group’s decision to team with Blue Cross/Blue Shield of North Carolina to create that state’s first commercial accountable care organization (ACO).  Watch Jeff James answer 5 […]
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New technologies are breaking down data silos

The highest quality data does no one any good if the information is locked up in silos, unable to be shared. Now the tools of health care are changing in a way that will allow data to be accessed and analyzed. Electronic Medical Records (EMRs) and Health Information Exchanges (HIE) represent two of the top […]
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Is your data organized to allow for utilization?

Even early-adopter health systems – leaders in the transition to population health management who have relied on data for some time – find it valuable to review their analytics platforms and ask, ‘what can you do for me now?’ One such system is Mercy health system – a Pioneer ACO and participant in the Physicians Group Practice demonstration […]
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3 analytics deliverables credited with ACO progress

What does it take to create an accountable care organization that meets benchmarks in care delivery and proves to be profitable? Jeff James, Chief Executive Officer at North Carolina-based Wilmington Health, says metrics and analytics allow for his group’s ACO to exist. The ACO was formed as a partnership with Blue Cross Blue Shield of […]
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Documenting diagnoses makes a difference in care quality.

An often-repeated statistic warns that 8 million Americans have diabetes and don’t know it. There are similar claims about other chronic illnesses, like hypertension and chronic heart failure. If a patient doesn’t know they are missing a diagnosis, their health care provider may not either. The white paper Accurate coding: The foundation of accountable care explains that […]
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Focus on the future when developing your provider network

Every health system and provider organization entering into risk-based contracts needs to focus on the types of providers they want in their network. The type of providers they want will depend on the services they provide and the geographic coverage they need. However, a network should not be static as providers take on additional levels […]
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