What We Do
The current healthcare reimbursement structure does not take into consideration the cost, quality or experience of patient care. Inevitability, health plans and purchasers of healthcare are moving towards a value driven healthcare reimbursement structure that take these factors into account. An ACO serves as a foundation to allow providers to track and improve their clinical and financial performance.
The foundation that we are building includes the following initiatives:
Care coordination: Staff to assist the doctor and patient in navigating the health care system and receiving the care that they require in a timely manner.
Transitional care: Making sure that each patient who is discharged from a hospital, rehabilitation facility or nursing home is seen by their primary care provider within a short time after their discharge
Patient access to care: Reducing use of the emergency room by making it easier to be seen in the physician’s office in a timely manner
Access to information: A computer network that shares information between the physician’s office, hospital, post-acute care and patients themselves in order to make sure that all known information is available to the physicians at the time that they are providing care. This should also help reduce unnecessary duplicate testing and treatment.
Under the Medicare Shared Savings Program, ACOs will report on 33 quality metrics, which are divided into four categories:
Care coordination and patient safety
Care for patients with chronic diseases and other acute illnesses
The collection of quality metrics help providers determine how and where they can improve on delivering high-quality care and spending health care dollars more wisely.