Turn data into action with analytics that provide a 360 degree view of the patient and manage populations. By transforming raw data from all sources into analytics and using predictions to understand the future, a 360 degree of the patient is finally possible. Our solutions will help you meet compliance initiatives, MLR requirements, and ROI; prepare for PCMH and ACO business models; and improve patient population outcomes. Learn more about more about Elsevier / MEDai analytics and how we can help you to understand the past, control the present and change the future.
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Posts Tagged ‘ACO’
Analytics for a 360 Degree View of the Patient and Population Management
Health Plan Analytics for Accountable Care Organizations
With the ACO initiative scheduled to launch in January 2012, hospitals, physician practices and insurers are announcing their plans to form ACOS.
The ACO model requires providers along the continuum of care to share the responsibility for providing care to patients and take on risk together as one entity. Health plans can play an important role in ACOs because they track and collect data on patients, which is critical for coordinating care and reporting on the results. Health plans can play a critical roles in such initiatives by providing tools and data to support population based care, providing programs and staff to better coordinate care, and structure provider contracts to reward high quality performance and reductions in cost. While providers and health plans work on creating new reimbursement models to support these changes, provider care systems are finding an escalating need to have access to analytics derived from claims data.
The joint webinar by Grow Forward and MEDai was designed to provide health plans with a base understanding of how their wealth of analytic information can provide significant value to provider care systems that are taking on the challenge of Accountable Care.
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10 Key Takeaways from ACO Power Session – Continued
“Building a Successful ACO will require more than filling the requirements of Accountable Care Act”
As we posted last week, here are the next five key takeaways that make up the 10 Key Points from the ACO Power Session. (for the first five takeaways, see previous blog post).
6. Data sharing is a key component of ACO program. CMS is proposing to make certain data elements available to ACOs on a monthly and quarterly basis to ensure that they have the right information to improve quality care, improve the health of their beneficiary population and create system efficiencies. An ACO will receive aggregated metrics on the assigned beneficiary population.
a. ACOs will be data-intensive and IT will be a key component; ACOs will especially need to develop robust data access and analytic capabilities.
7. ACOs that include federally qualified health centers (FQHCs) and rural health clinics (RHCs) in their network can be eligible for a higher percentage of any shared savings for including these providers.
8. ACOs are required to establish a legal entity and a governing body with authority to execute its statutory functions.
9. ACOs must commit to the program for the full three years and CMS is proposing to hold a percentage of the ACOs’ shared savings to ensure that they fulfill their pledge
10. Providers need to prepare for the new environment whether or not ACOs become widespread. Providers need to begin to put into place the elements that will improve their business model, irrespective of ACOs.
- Improve quality
- Reduce costs
- Craft a business model that can thrive under a low per capital utilization environment
- Coordinate care with other providers and/or identify potential partners
A critical success factor for ACOs will be their ability to obtain, analyze, and act on cost and utilization data. Critical decisions regarding primary care physician selection and management, risk score and financial management depend on obtaining and analyzing data generating within an ACO.
To learn more about how to incorporate advanced analytics in your ACO strategy, call 866-422-5156 or send us an email on the Contact Us page to answer any questions that you may have.
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