Accountable Care Organizations (ACOs) are a tool promoted by the Centers for Medicare and Medicaid Services to help achieve the "Triple Aim" of better care, better health, and lower costs. ACOs integrate high-performing healthcare providers into coordinated systems using financial incentives to encourage population health management. While the goals of ACOs are to improve quality and lower costs, setting them up requires significant investments in care coordination infrastructure and overcoming cultural barriers. Physicians will be central to developing successful ACO models. Overall, ACOs are one part of various bundled payment and value-based initiatives aimed at shifting to alternative payment models.
Kalkhof Final Va Dc Hfma Strat Mgd Care And Hc Reform 9 28 12chriskalkhof
Post-ACA reform… the majority of provider revenues will come from contracted arrangements. Financial sustainability will be linked to an organization’s ability to manage patient populations across care continuums in alignment with physicians. These evolving business models will require a rethinking of traditional pricing and payer contracting strategies.
Hugh Reeve: How is the NHS in Cumbria adapting to lessons from the Alternativ...The King's Fund
Hugh Reeve draws on the lessons that can be learnt from the Alternative Quality Contract and shares how Cumbria Clinical Commissioning Group have started to put those lessons into practice.
Kalkhof Final Va Dc Hfma Strat Mgd Care And Hc Reform 9 28 12chriskalkhof
Post-ACA reform… the majority of provider revenues will come from contracted arrangements. Financial sustainability will be linked to an organization’s ability to manage patient populations across care continuums in alignment with physicians. These evolving business models will require a rethinking of traditional pricing and payer contracting strategies.
Hugh Reeve: How is the NHS in Cumbria adapting to lessons from the Alternativ...The King's Fund
Hugh Reeve draws on the lessons that can be learnt from the Alternative Quality Contract and shares how Cumbria Clinical Commissioning Group have started to put those lessons into practice.
This infographic summarizes the challenges, a snapshot of HIE current status, and components of successful HIEs. Health Information Exchanges (HIEs) provide the capability to electronically transfer clinical information between healthcare systems to facilitate a more coordinated and efficient patient care. The HITECH Act has stimulated development of HIEs through awarding incentive funding to aid healthcare providers meet meaningful use regulations of interoperative EHRs. As of 2012, eHealth Initiative (eHI) has identified over 230 HIEs spanning from multi-state, single state, counties, cities and even single health systems.
Presentation made by Dr. Carolyn A. (Cindy) Watts on the 5th of November, 2012 during the live webinar hosted by VCU Department of Gerontology (discussion moderated by Dr E. Ayn Welleford) - review recording of webinar at http://www.alzpossible.org/wordpress-3.1.4/wordpress/alliedhealth/
2013-01 Building a Framework for Sustainable ACO Enablementimagine.GO
Insurers and Providers must first agree on how to share risk. After that, begins the hard part. For ACOs to last, unlike managed care in the 90's, they will need a sustainable framework to achieve cost, quality, and patient experience.
This infographic summarizes the challenges, a snapshot of HIE current status, and components of successful HIEs. Health Information Exchanges (HIEs) provide the capability to electronically transfer clinical information between healthcare systems to facilitate a more coordinated and efficient patient care. The HITECH Act has stimulated development of HIEs through awarding incentive funding to aid healthcare providers meet meaningful use regulations of interoperative EHRs. As of 2012, eHealth Initiative (eHI) has identified over 230 HIEs spanning from multi-state, single state, counties, cities and even single health systems.
Presentation made by Dr. Carolyn A. (Cindy) Watts on the 5th of November, 2012 during the live webinar hosted by VCU Department of Gerontology (discussion moderated by Dr E. Ayn Welleford) - review recording of webinar at http://www.alzpossible.org/wordpress-3.1.4/wordpress/alliedhealth/
2013-01 Building a Framework for Sustainable ACO Enablementimagine.GO
Insurers and Providers must first agree on how to share risk. After that, begins the hard part. For ACOs to last, unlike managed care in the 90's, they will need a sustainable framework to achieve cost, quality, and patient experience.
As business, you have two choices: let rising healthcare costs continue to eat away at your profits – or do something about it. The old healthcare model does not work, and healthcare reform laws will not lower your costs. Employees are overweight, more susceptible to illness and chronic disease and have no understanding of the true costs of healthcare or even know how to find the best care. A new paradigm is needed to control rising healthcare costs. In the care setting, the traditional insurance models distort the reality of health care for its most important consumer – the patient. Employers should shift the paradigm to allow the patient to step above the fog and find themselves as powerful consumers with the ability to demand higher value and more cost-effective care.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
Presentation delivered by Bryan Starnes, Chief Financial Officer, Affinity Living Group at the marcus evanc Long-Term Care & Senior Living Central CXO Summit, October 2016, in Chicago.
Direct to Employer - Dealing With Narrow Networks in the 'New Exchange World'McKonly & Asbury, LLP
This webinar was hosted by Tyler Wenger and Suzanne Sentman from McKonly & Asbury with special guest host Ernie Tsoules from Rhoads & Sinon.This presentation addressed the fact that self-insured employers are increasingly seeking to reduce employee health care costs. A new model of achieving this goal is taking hold in the market by employers contracting directly with new types of health care provider networks, commonly referred to as “narrow networks." This session explored the evolution of these new arrangements and its impact on employers, health care providers and employees. The session also addressed the key business and legal issues that are important to consider in developing these new relationships.
Check out our Upcoming Events page for news and updates on our future seminars and webinars at http://www.macpas.com/events/
Telemedicine challenges and opportunities slidecastDavid Harlow
Slidecast of preso at http://www.slideshare.net/DavidHarlow/telemedicine-challenges-and-oppoertunities See slides at that link for live links to other resources.
Beyond HIPAA: Digital Health Opportunities & Regulatory Land MinesDavid Harlow
An overview of state and federal regulatory schemes that affect digital health - beyond HIPAA - together with a discussion of the opportunites presented and strategies for dealing with the regulatory environment
Health Data Privacy (and a little FDA mHealth) RegulationDavid Harlow
I spoke at the Cambridge, MA Health Innovators Meetup January 20-15 meeting, The overall theme of the meeting was Launching & Funding Healthcare Innovation: Legal & Business Considerations. I focused on health data privacy and security and the FDA guidance on determining when an mHealth app is a medical device. A good time was had by all.
Digital Health: Apps, Analytics & AgenciesDavid Harlow
Introduction to Digital Health presented at the Massachusetts Bar Association "Hot Topics in Healthcare" program on December 10, 2013. For more information, see related posts at HealthBlawg.com.
MCLE Health Law Basics Plus 2013 - Post-Acute CareDavid Harlow
My annual presentation at the Massachusetts Continuing Legal Education two-day extravaganza intro to health law.
See resources collected at http://j.mp/MCLEHealthLaw
Patient Consent to the Use of Data: Are We Asking the Wrong Question?David Harlow
In this presentation at #StrataRx 2013 I explore the notion of building big data analytics on top of a data store populated by health record information obtained as a result of patient requests. Why? Because doing it that way would bring the data out from under HIPAA and HITECH regulations. Patients could contribute as much or as little of the data as they wish, patients could be compensated for their contributions, and other pesky HIPAA restrictions would fall by the wayside. I used one company's newly-announced service as an example, but there are others in this space as well.
See livetweets of presentation at: http://www.healthblawg.com/2013/09/david-harlows-hipaa-and-hitech-presentation-at-stratarx.html
Press coverage of this presentation: Solving Healthcare's Big Data Analytics Security Conundrum - CIO.com – http://shrd.by/8qCxmo
Health Care Social Media - An Introduction to Engaging Intelligently and LegallyDavid Harlow
Learn more about the value of social media tools, the range of issues they present, and some key strategies for using these tools effectively while steering clear of trouble by social media expert and charter member of the Advisory Board of the Mayo Clinic Center for Social Media, David Harlow.
Engage David Harlow as a keynote speaker or consultant to your organization: http://bit.ly/tgQhmU
One recent review: '@healthblawg is so good I just tend to listen vs tweet'
You may purchase the audio and a transcript of this webinar at http://bit.ly/uqBiBi
Health Care Social Media for Medical Device Manufacturers - FDA - Presentatio...David Harlow
Health Care Social Media in the Face of Continued FDA Regulatory Uncertainty for Medical Device Manufacturers, Presented at MassMEDIC conference 05 13 2011
Accountable Care Organizations - The Camel's Nose Is In the Tent
1. Accountable Care Organizations
The Camel’s Nose Is In The Tent
David Harlow JD MPH
THE HARLOW GROUP LLC
23rd Annual
Louisiana Society of Hospital Attorneys blog • healthblawg.com
Health Law Symposium twitter • @healthblawg
November 8, 2012
Baton Rouge, LA
9. ACO is one tool to get providers
to manage a population of
patients
10. How? Financial incentives.
$18,000,000
$16,000,000
$14,000,000 Yr 1 Yr 2
$12,000,000 Yr 3 Yr 4
$10,000,000
Yr 5
$8,000,000
$6,000,000
$4,000,000
$2,000,000
$0
Billings
Dartmouth
Everett
Forsyth
Geisinger
Marshfield
Middlesex
Park
Nicollet St. John's
Michigan
Graphic courtesy Jaan Sidorov, Disease Management Care Blog
23. Even if an ACO is not in your
immediate future, these principles
will affect you
Bundled Commercial
Payments ACOs
Pay for Other
Performance Innovations
25. Jeff Goldsmith: Suggests 3
commercial ACO payment systems
for 3 different types of providers
Primary
• Risk-adjusted
capitation
Emergency
• Fee-for-
service
Specialty
• Bundled
payments
26. Bundled Payments
MSSP is just one arrow Comprehensive Primary Care
Initiative
Financial Alignment Initiative
in the quiver FQHC Advanced Primary Practice
Demo
•Medicare Shared Savings Program Graduate Nurse Education Demo
– “Traditional” ACO Health Care Innovation Awards
Independence At Home Demo
•Advance Payment Initiative Initiative to Reduce Avoidable
•Pioneer ACO Hospitalizations Among Nursing
•Other CMS Innovation Center Initiatives Facility Residents
Innovation Advisors Program
Medicaid Emergency Psychiatric
Demo
Medicaid Incentives for the
Prevention of Chronic Diseases
Million Hearts
Partnership for
PatientsCommunity-based Care
Transitions Program
State Innovation Models Initiative
Strong Start for Mothers and
For details, see: innovations.cms.gov/initiatives/ Newborns
37. David Harlow JD MPH
Thank You THE HARLOW GROUP LLC
for contact info
txt dharlow to 50500
or scan the QR code
harlowgroup.net
healthblawg.com
twitter.com/healthblawg
david@harlowgroup.net