Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Accountable Care Organizations, Bundled Payments and More. Presented at AAOS Practice Forward 09 2011

3,697 views

Published on

Specialists and other health care providers must embrace cultural change in order to succeed under Accountable Care Organization rules, bundled payment initiatives, and other CMS and private payor innovations

Published in: Health & Medicine, Business
  • ⇒⇒⇒WRITE-MY-PAPER.net ⇐⇐⇐ I love this site. It always finds me the best tutors in accordance with my needs. I have been using it since last year. The prices are not expensive compared to other sites. I am glad I discored this site:)
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • A professional Paper writing services can alleviate your stress in writing a successful paper and take the pressure off you to hand it in on time. Check out, please ⇒ www.HelpWriting.net ⇐
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Sex in your area is here: ❶❶❶ http://bit.ly/39mQKz3 ❶❶❶
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Follow the link, new dating source: ❶❶❶ http://bit.ly/39mQKz3 ❶❶❶
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

Accountable Care Organizations, Bundled Payments and More. Presented at AAOS Practice Forward 09 2011

  1. 1. The Accountable Care Organization and the Specialist<br />American Academy of <br />Orthopaedic Surgeons<br />Practice Forward: Managing Your Practice in an Era of <br />Health Care Transformation<br />Chicago, IL<br />September 23-24, 2011<br />David Harlow JD MPH<br />The Harlow Group LLC<br />blog • healthblawg.com<br />twitter • @healthblawg <br />
  2. 2. Disclosure<br />My clients include health care providers and health-care-related businesses, including on-line patient-facing services. As a lawyer, I can’t really tell you who they are.<br />I speak about health care business, legal and policy issues on a regular basis, at live conferences and via webinars. Some organizers of these events cover my expenses and/or offer honoraria.<br />None of these relationships constitute a conflict of interest with respect to today’s presentation.<br />
  3. 3.
  4. 4. We are challenged by shifting sands<br />
  5. 5. High-performing specialty practices can be integrated into high-performing health care systems<br />
  6. 6. What are the federales trying to accomplish?The “Triple Aim”Better careBetter health Lower costs<br />
  7. 7. ACO is one tool to get providers to manage a population of patients<br />
  8. 8. How? Financial incentives. <br />Graphic courtesy Jaan Sidorov, Disease Management Care Blog<br />
  9. 9. Whatis an ACO? <br />
  10. 10. ACO Basics<br />Single Entity<br />Three-year commitment<br />One-way or two-way risk-sharing<br />PCPs and broader network <br />5000 patient minimum<br />Patient engagement<br /> Patient-centeredness<br /> Stark/AKS<br /> IRS<br /> Antitrust<br />
  11. 11. ACO regulations coordinate across numerous Federal agencies<br />
  12. 12. All in all, ACO risk/reward ratio seems skewed<br />
  13. 13. IT infrastructure cost estimate >$1.5m<br />
  14. 14. More details from the ACO rules, and traps for the unwary<br />
  15. 15. Rules not finalized yet for a program due to begin very soon<br />
  16. 16. Over 60% of health care provider executives say they intend to form an ACO<br />
  17. 17. Culture of Collaboration<br />
  18. 18. Focus on opportunity for specialists<br />
  19. 19. Even if an ACO is not in your immediate future, these principles will affect you<br />
  20. 20. Commercial plans are non-standardized<br />
  21. 21. Jeff Goldsmith: Suggests 3 commercial ACO payment systems for 3 different types of providers<br />
  22. 22. Bundled Payments<br />CMS Bundled Payment Initiative<br />ACO “lite”<br />MS-DRG-specific<br />Gainsharing<br />. . . Bundled Payment Pilot - 2013 <br />
  23. 23. What can you do now to prepare for the future? <br />
  24. 24. Specialists are key components of any compre-hensive network<br />
  25. 25. You cannot manage what you do not measure<br />
  26. 26. Opportunity: Be the go-to guys (or gals) – cost-effective specialists<br />
  27. 27. .<br />
  28. 28.
  29. 29. for contact info <br />txt dharlow to 50500<br />or scan the QR code<br />harlowgroup.net<br />healthblawg.com<br />twitter.com/healthblawg<br />david@harlowgroup.net<br />Thank You<br />David Harlow JD MPH<br />The Harlow Group LLC<br />

×