...Mr. Salter wants me to analyze the Affordable Care Act of 2010 as it relates to Accountable Care Organizations. Becoming an ACO has several advantages as well as disadvantages. In my opinion, we can get Bobcat out of the red by becoming an ACO, meaning putting emphasis on providing quality and efficiency. According to Dr. Michael Nowicki, Affordable Care Act (ACA) of 2010 places significant restrictions on the expansion of physician-owned hospitals. Accountable Care Organizations (ACOs) seems like a perfect solution for under ACA because ACOs are not owned by the physicians. According to Dr. Nowicki, Accountable Care Organization (ACO) is a healthcare organization that coordinates care among healthcare organizations and physicians. Therefore, ACOs are not owned by the physicians. The risk is shared by all parties involved. This can attract more physicians to become part of Bobcat Integrated Healthcare System. ACA also plans to reduce unnecessary hospital readmissions and hospital-acquired infections by using financial penalties to the responsible healthcare organizations. A key element of an ACO is that some portion of its reimbursement is tied to accountability. An ACO is accountable not only to the patients but also to the third party payers for the quality, cost and efficiency of...
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...Accountable Care Organizations (ACO) When some doctors, healthcare providers and hospitals get together to give their patients a high quality and well coordinated care, forms an organization. This organization is known as Accountable care organizations. ACOs are based on integrated systems of delivery and posses a range of doctors and physicians, virtually connected. The aims of this organization is to look after the patient and deliver them right treatment at the right time and also coordinate all the efforts so not to overlap or repeat anything. This results in reduction of the medical errors. This procedure saves the cost of medical treatment. Another important aim is to stop spread of diseases through preventive measures and spreading education. The most important objective is to bring reduction in costs and reduce the waste of money in healthcare system. The conditions which will result in ACOs,if physicians and other related professionals are practicing in a group, or they have form a network or there exists a collaborations between physicians, hospitals and professionals. If these conditions exist anywhere it will be called as ACOs. The requirements any ACOs need to fulfill are, it must have a formal legal framework to distribute the savings, it should possess a minimum of 5,000 numbers of beneficiaries, it should agree to take part for three years or so. An organization must fulfill these requirements to form a ACOs. (American Hospital Association, 2010) This new treatment...
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...Accountable Care Organizations: Key to Transforming Healthcare? The Talia Goldsmith, MHA Candidate 2011 Suffolk University Sawyer Business School HLTH 890AE: Healthcare Strategic Management Professor Richard H. Gregg, M.A., M.B.A. April 28, 2011 Table of Contents Objective .....................................................................................................................................3 Introduction ..............................................................................................................................3 Overview of ACOs as a Mandate and an Opportunity for Healthcare Organizations............................................................................................................................4 Examples of Missions, Visions, Values and Goals for ACOs........................................6 Mission ................................................................................................................................................. 6 Vision ....................
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...ACO 1 Accountable Care Organization Need for setting up a network infrastructure at SPA ACO During the transformation phase of the rehab to SPA ACO, activities of a pharmacy and a physician group can also be integrated through use of IT systems. Networks can be used by enterprises to enhance operational effectiveness, enhance organizational agility, and increase ability of the management to control operations across the organization (At & T, 2007). While changing the process system at the rehab to accommodate IT changes in the way computers are connected has to be done. By using Electronic Health Records information can be shared amongst identified parties. To ensure information is transferred effectively amongst physician groups, and pharmacies, networks have to be established amongst the rehab, and identified organizations. Information systems needed in an ACO At present Accountable Care Organization (ACO) are being advised to make use of advancements offered by Information Technology. Information systems that are most required by health organizations are data management systems, systems to maintain electronic health records, and personal health record exchanges. By automating the process of documenting and managing vast array of information about patients, coordination of activities at the hospital can be achieved, and the hospital can be accountable for the overall care provided within its premises (Glaser & Salzberg, 2010). Information systems are ...
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...proposed the guidelines for Accountable Care Organisation (ACO) under the Medicare shared saving Program. The Patient Protection and Affordable Act authorises CMS to create the MSSP that help doctors, hospitals and other health care provider in coordinating care for Medicare patients through ACO. An ACO is a network of group of provider and suppliers who work together to provide high quality care for the Medicare Fee-for service patients they serve. The ACO model was developed by Fisher, that private hospitals and organisation can be grouped into virtual organisation that is accountable for cost and quality of the range of care services delivered to Medicare patients. ACO work to provide high quality care to Medicare enrolees while simultaneously reducing health care costs. ACO is accountable to beneficiaries of Medicare for cost, quality and care. Till now eight private health insurance plans have entre with provider into ACO agreements that shares a payment risk model. Keeping the cost below a benchmark will make providers eligible for bonuses and incentives (Berenson & Burton, 2012). Objectives of ACO The main goal of ACO is to provide effective, accessible and coordinated care to patients it serves. ACO assures that care is delivers in a cultural component manner. The organisation aims to deliver seamless supreme quality care to beneficiaries of Medicare. In ACO the beneficiaries and providers work as true partners in ACO’s care decision making process. The satisfaction...
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...Abstract Accountable Care Organization is a healthcare organization characterized by a payment and care delivery mode. lt seeks to tie provider reimbursements to a quality metrics and reductions in the total cost of care for an assigned population of patients. A group of coordinated health care providers form an ACO, which then provides care to a group of patients. The ACO may use a range of payment methods, (e.g. capitation, fee-or-service with an asymmetric or symmetric shared savings). The ACO is accountable to the patients and the 3rd party payer for quality, appropriateness, and efficiency of the health care provided. The Centers for Medicare and Medicaid Services (CMS), an ACO is considered an organization of health care providers that agree to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program. This paper identifies the differences between HMO’s and ACO’s but also correlates the similarities between ACO’s and Patient Center Medical Home (PCMH). The ACO’s place a degree of financial responsibility on the providers in hopes of improving care management and limiting unnecessary expenditures while continuing to provide patients freedom to select their medical services. The success and challenges of ACO are identified and explored. By increasing care coordination, ACO’s can help reduce unnecessary medical care and improve health outcomes, leading to a decrease in utilization...
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...Accountable Care Organizations May 5, 2012 Accountable Care Organizations represent a strategy outlined within the Affordable Health Care Act to control costs and improve quality. They require partnerships between providers, hospitals, and communities. There are challenges in health systems where private practice is the predominant practice structure. Key issues and challenges to an effective ACO are cost reduction and utilization management, business model shifts, risk sharing and population management, consolidation, a changing role of IT and value of data, physician integration, clinical process improvement, and consumerism and the patient. How to reduce cost is a question that has been pursued, and it needs to be looked at, as well as utilization of management. Does this mean that homes for critically ill children or a hospital that cares only for transplant patients is becoming the future of health care in the USA? Why Accountable Care Organizations? No one will dispute the high cost of health care in the United States. Critics often say that it is the result of how health care providers are paid. They claim that—with a fee for each service— this results in increased and wasteful spending. Critics say that this system rewards providers just for doing more procedures, rather than for providing efficient and high-quality care (Matthews, 2012). In an effort to handle this problem, the United States Government has passed legislation: The Affordable...
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... Accountability is the act of taking responsibility for ones actions; many would say that they are accountable but does it hold true when one is face with the moral responsibility of taking responsibility for one’s own actions? In the health care field it, is very important for all health care providers and health care staff to have a moral obligation and duty to be accountable for his/her everyday actions when dealing with the health and welfare of the lives of others. Why is accountability important in the health care industry? Answers to questions about how to define, monitor, and assure health care quality have proven elusive. For more than a decade, various sectors of the industry have pursued an approach based on the concept of accountability the idea that health plans, insurers, hospitals, physicians, and other providers should take responsibility for their activities by demonstrating the quality and value of their services. Central to this strategy is the production, collection, and reporting of data designed to measure different aspects of quality and performance (National Health Policy Forum, 1998). How is an employee’s accountability measured in the health care industry? An employee’s accountability is measured by several factors, including professional competency, legal, ethical and moral conduct, and promotions. Other parties that can be held accountable are entities such as federal and state regulators, insurance companies, and employers. Other ways to...
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...use the same methods of collecting information as in the previous case studies. I feel very frustrated because there is a lot of ignorance within our society, lack of information and understanding of people who disregard others because of were they come from. Firstly I make reference to the NMC’s guidance on anti-discrimination practice; As a qualified nurse I am personally accountable for my practice, and when caring for my patients I must; 1.1 Respect the patient as an individual 1.2 Protect and support the health needs of individuals 1.4 I have a duty of care to patients, who are entitled to receive safe and competent care. 2.3 As a registered nurse I am personally accountable for ensuring that I promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs. 2.4 I must promote the interest of patients. This includes helping individuals and groups gain access to health and social care, information and support relevant to their needs. The NHS is accountable for all acts and omissions that relate to equality and human right legislation like the Equality relations Act, The human Rights Act (1998) The Disability Discrimination Act (2006). The legal enforcement authorities such as, the disability rights commission, equal opportunities commission, The Equality and Human Rights commission require adherence from all NHS bodies. The equality...
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...misconceptions many have about what ails them and transparency will allow the consumer to make choices based on facts and costs rather than being led about in the direction providers would have them to go. With transparency the patient gets to decide where it is they want to go to get the most value for their dollar while still receiving quality medical care. There is also a desperate need for insurance for all Americans, and the idea of Universal Coverage is not a bad idea at all. It would be more feasible to provide protection for citizens rather than place the burden of their care on the taxpayers who have received no benefit from a medical professional, but is held accountable any way. In an effort to address the inconsistencies of our health care system, the Patient Protection and Affordable care Act creates Accountable Care Organizations who provide financial incentives to health care systems to improve patient...
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...Patients are the number one stakeholders in a hospital. They are the ones who choose which hospital to see when in need of proper medical attention. By proper, one means professional and safe practices. An electronic health records system offers both, professional and safe practices. Implementing this system will make a patient feel better about the care they receive in such hospital. Simply because all their information will be available when they need the care. This can make things easier for the patient. With the use of this system, their allergies and medications can easily be tracked, this will advance their medical care. Also, this idea will help patients avoid unnecessary, and costly treatments. When a patient is ill, he or she might...
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...Background Ascension Health is considered the largest nonprofit health care in the United States. Therefore, there is many positions from doctors to staff members throughout all the facilities in the country. Ascencion Health has two systems that help them to plan, organize and control their data from Patients that come in for treatments to billing. They have web portals, nurse navigators, and hospitals programs.” In order for me to describe the manager’s functional role of this organization website, in which remarks that technical Managers are responsible for managing all infrastructure, performance and availability of all technology devices in the organization's set-up. 3 At Ascension Health, their operating model guides them on the better way to make decisions, they work together, which implies “team work”. They have a strong System Office that provides strategic services, as well as thought leadership. Ascension Health hospital affiliates and health facilities are the foundation and the center of their model. All other business units are focused on strengthening the position of the hospital affiliates and health facilities. Their primary principle of operation is to maintain...
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...of how each works and see which one would be better suited to help increase HCAHPS scores. First we need to know what HCAHPS are and why they are so important to the healthcare industry. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) has been around since 2005 and is going to effect payment from CMS for the hospitals. This payment affects the reimbursement of patients discharged from October 1, 2012 and forward. By holding health care providers accountable for both the cost and quality of care will hopefully reduce poor care and reward high performing providers. This survey that the patients participate in gives a report card on how a hospital is doing per the patient’s perspective. It also is an incentive program for the hospitals to improve their quality of care. (HCAHPS, 2013) There were three goals that shaped HCAHPS survey. First, it was designed to compare date on patients’ perception of the care they received in the hospital. That data could then be compared to other hospitals in the nation. Second, the hospitals would then report the data public with the design to create incentives for the hospitals to improve on their quality of care. Third, the public reporting holds the hospital and the providers accountable on their quality of care delivered and increases...
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...After several attempts by others to step in and help fix the situation at the Beth Israel Hospital and Deaconess Medical Center, Paul Levy stepped in and applied for the job. Paul’s willingness to attempt to undertake the situation at BIDMC and save the hospital from being sold to a for-profit organization is very much in line with this ambition. The hospital was in desperate need of a competent leader who possessed the qualities that would turn around and save the non-profit company. Before he was hired he made several demands and each of those demands showed effective forms of leadership as seen through the political and symbolic frames. He established himself as a strong leader with the power to be the deciding force in decision making. By making the demands that he did it gave Levy the upper hand in the struggle for power with the board even before he was ever offered the position. Also, symbolically, this showed all employees and the board of directors that he was going to be a powerful leader. Picking the people who would be on the task forces was not an easy task. Paul did not want the steering committees to be too big because he wanted to make sure that people were productive and able to participate. He wanted to make sure that they had a broad representation of the hospital by the faculty and the administrative staff. There needed to be people who knew something about the area so they would know how to carry out the recommendations. The role of the steering committee...
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...Every healthcare environment such as hospitals, nursing homes, ambulatory care centers, nurses have always had the closest relationship with patients and their families. Nurses assess, monitor, provide care and meet patients’ needs, relay information between physicians and patients, advocate for patients and families. Nurses have not being involved in making significant policy decisions to high quality patient care but as our country focuses on healthcare reform which will guarantee that all American have right to excellent and reasonably priced health care, nurses’ roles and responsibilities are expected to change from patient care to taking responsibilities on many new health care imperatives. According to the report of IOM, nurses should be associates with doctors and healthcare professionals in restructuring healthcare in our nation. Nurses’ responsibilities will become more prominent in continuity of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics. The purpose of this speech is to enlighten nurses about the changes that will be anticipated in their roles as healthcare professionals as these reforms take place in the healthcare industry. Continuity of care is a system of patient care integration that follows patients over time through comprehensive arrays of health services across all levels of care. It allows patients’ care to be managed efficiently from primary physician care to in-hospital or critical care settings and to medication...
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