Monday, August 23, 2010

MSPs Should Be on the Lookout for ACOs

A new acronym (ACO) to keep on our radar screen. The goal of such organizations is to keep patients healthy AND be cost-efficient. According to BNA, accountable care organizations "are designed to keep patients healthy and out of intensive care settings, while simultaneously shifting reimbursements to pay based on the achievement of top performance goals that drive improved patient outcomes and cost-effectiveness."

The Centers for Medicare & Medicaid Services (CMS) is working on draft regulations that will define what constitutes an ACO. The CMS-regulated ACO program is set to begin in 2012. Currently, there are some ACO models are emerging from Physician Group Practice organizations.

The purpose of the ACO program is to reward providers with higher reimbursement if they attain positive patient outcomes and are successful at promoting patient wellness. The idea is that it is more costly to reimburse providers for the treatment of illnesses; therefore, quality healthcare can be made more cost-efficient if they strive for the maintenance of patients' good health.

It will be interesting to see whether or not MSPs are asked to assist with monitoring "top performance goals" as part of the final ACO rules.

Source: BNA

1 comment:

Anonymous said...

As a result of the Patient Protection and Affordable Care Act (PPACA), Accountable Care Organizations (ACOs) will be developed to assess various aspects of health delivery services. ACOs will likely require some form of credentialing activity, which may create an increased need for credentialing functions and staffing in the future. This is a hot topic to monitor!
Jodie Chant, CPCS, RHIT