Implementing Comprehensive Payment Plan Or Ppo Plan Essay

756 Words Apr 14th, 2016 4 Pages
Knowing that the Accountable Care Organizations was designed for quality care it also focus on the revenue that is bringing to the organizations and even better how it can lower cost. With ACO we are suppose to see lower cost and more improved quality care. ACOs are something that can either be good or bad for your company. It has been proven to lower the cost for the payers. ACO’s has payment aligned with the quality and efficiency of care delivered. ACO is more of a new Medicare payment used to help expand Medicare and private payers. ACOs are not an HMO plan or PPO plan. ACOs are there to implement comprehensive payment reform. Some ways that ACOs are trying to implement payment reform, there are three ways in payment options. These options are Shared Savings, Partial Capitation/Bundled Payment Options and Full Capitation. Shared Savings “is a payment strategy that offers incentives for provider entities to reduce health care spending for a defined patient population by offering them a percentage of any net savings realized as a result of their efforts.” [1] In the ACO’s Shared Savings lets us understand that there are two basic forms; one-sided form is when the fee-for-service payments is below the ACO. One sided helps bring in more ACO’ with no shared losses. Two sided is when the “ACO contracts to share in savings if FFS care expenditures for a defined population are below benchmark; and share in “losses” if FFS expenditures are above the benchmark. ACO…

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