Case Study Of C. O.

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A.C.O for INOVA

First I would like to thank you for giving me this chance to share my opinion and finding on this issue of forming an A.C.O. The Centers for Medicare and Medicaid Services (C.M.S) defines an Accountable Care Organization as a "a healthcare organization characterized by the coordinated care efforts of hospitals, physician groups, insurance agencies, and other healthcare stakeholders who seek quality improvement while being accountable for the cost, efficiency, and overall care of a defined group of patients ” (A.C.O - C.M.S, 2015). The goal of an A.C.O is to “deliver high quality care” and reduce health care expenditure by “avoiding unnecessary duplication of services and preventing medical errors” (A.C.O - C.M.S, 2015). A.C.O
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The first one is that it is highly imperative to be fully aware of and we meet the requirements put in place by the C.M.S to form an ACO. The C.M.S has established the Medicare Shared Savings Program (MSSP) that uses the A.C.O model in order to improve the quality of care to Medicare beneficiaries and other patients. “Under the MSSP, the ACO must have at least 5,000 Medicare beneficiaries while meeting certain quality measures for a time span of three years” (American Academy of Family Physicians, 2011). Another major requirement that we will have to meet is the 33 quality performance standards set forth by the CMS that requires ACOs to meet while saving money, to prevent the ACO from merely reducing costs without improving quality of care. Since our organization has been working with Medicare patients and we are currently providing high quality of care to our patients it’s my opinion that with the proper management in place we will meet all the requirements of the …show more content…
I also suggest consulting other well-established ACOs that work under MSSP. Since those ACOs have been inspected and approved to meet the requirements of the CMS we can model their quality, financial metrics and learn which management strategies they implemented. I’ve come across the following methods and objectives that are currently being used by many ACOs. “Having a designated quality officer or manger to comply with CMS quality measures; integrating new and innovative technologies like electronic medical records to eliminate duplicative data and enhance data mining; and developing incentives to physicians for improving quality of care while reducing costs”. (Koury, C.

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