Accountable Care Organizations (ACOs)

An accountable care organization (ACO) is type of managed care organization in which physicians, hospitals and other providers takes responsibility for the health and wellness of a population of patients, including responsibility for high quality, appropriateness, and efficiency of the care provided.

Dr. Ward’s Slides from AMGA ACO Learning Collaborative, Chicago, July 14, 2011

ACO Strategy, ACO Structure & Governance, Health Information Technology, Modeling Methods /

Presentation entitled “Developing the Economic Model for Success” from day 2 of the American Medical Group Association’s Accountable Care Organization Learning Collaborative, at the Swissotel in Chicago.  Attended by approximately 60 leaders of AMGA member physician organizations and other interested parties. Full page PDF format. Hand-out PDF format.

Dr. Ward’s Slides from AMGA ACO Learning Collaborative, Chicago, July 14, 2011 Read More »

Klar 2: The great attribution debates: Include specialists or not? Plurality or majority? Retrospective or prospective? Derived or declared?

2 Comments / ACO Reimbursement and Gain Sharing, Care Relationship Derivation (Attribution), Care Relationship Management /

Ron Klar, MD, MPH is a health care consultant with a long history of involvement in federal health care policy and health plan innovation.  He published a recent series of three posts (post 1, post 2, and post 3) regarding the draft rules of the Medicare Shared Savings Program (MSSP) in the Health Affairs Blog, an

Klar 2: The great attribution debates: Include specialists or not? Plurality or majority? Retrospective or prospective? Derived or declared? Read More »

Klar 1: Key points of agreement about changes needed for Medicare Shared Savings Program

3 Comments / ACO Reimbursement and Gain Sharing, Quality Measurement /

Ron Klar, MD, MPH is a health care consultant with a long history of involvement in federal health care policy and health plan innovation.  He recently did an analysis of the draft rules for the Medicare Shared Savings Program (MSSP), the Medicare program that establishes accountable care organizations (ACOs).  Dr. Klar published his critique as

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How to get a clearer picture of economic performance: Standard Cost and Payer Neutral Revenue

ACO Culture, ACO Provider Performance Analysis, Efficiency Measurement /

This morning, I read a set of slides published by the American Hospital Association (AHA) and the Health Research and Education Trust (HRET) called “Striving for Top Box: Hospitals Increasing Quality and Efficiency.” The report showcased the clinical integration and performance improvement efforts of three hospital-based health systems: Novant (North Carolina), Piedmont (Georgia) and Banner (Arizona).

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What makes teams effective? (2) Achieving the Piranha Club state

1 Comment / ACO Culture, Dr. Ward's Methods Notes /

Back in the mid-1990s, when I was working in the Center for Clinical Effectiveness at the Henry Ford Health System, I had the privilege and joy of being part of a team of smart, creative, passionate people working to transform health care.  The team included a core staff and an extended collection of collaborators from

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What makes teams effective? (1) Not being too role-focused

ACO Culture, Dr. Ward's Methods Notes /

I am a big fan of people in the fields of “usability” and “human factors.” These are engineering disciplines which have been applied to software engineering, more broadly to information technology and even more broadly to organizational effectiveness. Usability and human factors people focus on considering the mental and physical characteristics of users when designing

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Why do other countries have different attitudes about Health Economics?

3 Comments / ACO Culture, Cost-Effectiveness Analysis (CEA) /

Wednesday morning, I attended a thought-provoking panel discussion entitled “Is Health Economics an Un-American Activity?” — a reference to the McCarthy-era Congressional committees that judged Hollywood movie directors and others considered to be communist sympathizers.  The panel presentation was part of the annual meeting of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in

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Part 2 of Critique of AHA analysis showing higher ACO-related costs: Is being “local” worth 40% more?

1 Comment / ACO Reimbursement and Gain Sharing, Modeling Methods /

The American Hospital Association (AHA) engaged McManis Consulting to develop a model of ACO-related start-up and ongoing costs for Accountable Care Organizations (ACOs). The recently released analysis was based primarily on information gleaned from studying four case examples of provider organizations of different types and sizes that have already established many of the 23 types of

Part 2 of Critique of AHA analysis showing higher ACO-related costs: Is being “local” worth 40% more? Read More »

Part 1 of Critique of AHA analysis showing higher ACO-related costs: Still underestimating care management cost

1 Comment / ACO Reimbursement and Gain Sharing, Modeling Methods /

The American Hospital Association (AHA) engaged McManis Consulting to estimate the start-up and ongoing costs for Accountable Care Organizations (ACOs). The recently released analysis was based primarily on information gleaned from studying four case examples of provider organizations of different types and sizes that have already established many of the 23 types of “ACO activities”

Part 1 of Critique of AHA analysis showing higher ACO-related costs: Still underestimating care management cost Read More »

New “Pioneer ACO” Program to offer fast track toward capitation (but they don’t use the “C” word)

ACO Reimbursement and Gain Sharing /

The Center for Medicare and Medicaid Innovation has announced a new “Pioneer ACO” program, available to provider organizations that are already experienced in population management and bearing risk for performance and cost.  The new program has a three year term, with the first 2 years offering a higher level of risk/gain-sharing than is permitted under

New “Pioneer ACO” Program to offer fast track toward capitation (but they don’t use the “C” word) Read More »