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Four Reasons to Participate in the Next Generation ACO

Posted by Robert Tennant and Lynn Eckendorf, MBA, CCP, Executive Consultants, Advisory Services on Apr 6, 2015 9:08:00 AM

BetterwaySignTo advance value-based reimbursement, the Center for Medicare and Medicaid (CMS) Innovation Center announced the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery on March 10, 2015. CMS expects to accept approximately 20 ACOs into rounds one and two (2016 and 2017) of the program. Yet if resources are available and there are a greater number of high quality applicants, more than 20 participants may be possible.

Here are four reasons why existing ACOs experienced with coordinated care may want to consider applying for this new model:

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Topics: ACO, Population Health

Ten Key Areas of Focus for PCMH Success

Posted by Cindy Friend, RN, BSN, MSN, MBA/HCA, PCMH CCE, Executive Consultant on Mar 27, 2014 8:45:00 AM

A delivery system driven by quality of care, intervention, and preventative health is not only good for the patient but also for providers. Healthcare providers that are Patient-Centered Medical Homes often receive higher reimbursements, annual bonus payments, and more.

Achieving PCMH status, however, is not easy. Providers must focus on several areas to ensure success of the transformation. Here are 10 key areas for achieving PCMH transformation:

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Topics: ACO, PCMH, Care Coordination

What Are You Doing to Preserve Revenue Streams During a Merger or Acquisition?

Posted by Jay M. Tolchinsky, Principal on Mar 10, 2014 9:06:00 AM

Lately I’ve been talking to clients at both physician networks and hospitals about surviving in the age of healthcare reform. It doesn’t surprise me that the challenges related to mergers and acquisitions come up over and over again. Executives are concerned with protecting their revenue streams during consolidations, which are on an upward trend primarily due to ACOs, rising costs, and other reform initiatives. In fact, in a recent survey of hospital CFOs, one of the findings indicated that merger and acquisition activity is expected to remain high during 2014.

The question I hear most is, “How do I absorb a physician’s practice?” and, “How do I ensure my revenue streams keep moving?” If they’re going to be sold they may wonder if their service lines are going to stay the same. There are serious considerations on both sides. Add to that the challenges of ICD-10 as it relates to revenue cycle management, and CFOs have their work cut out for them. revenue20cycle20dollar20signs_jpg

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Topics: ACO, ICD-10, Revenue Cycle, Healthcare Reform, Mergers and Aquisitions

A New Era of Healthcare: Tearing Down the Barriers to Transform the US Healthcare System

Posted by Cindy Friend, RN, BSN, MSN, MBA/HCA, PCMH CCE, Executive Consultant on Jan 6, 2014 8:42:00 AM

I started my healthcare career right around the time the Berlin Wall fell. It was exciting and invigorating to see the crowds climbing the wall, determined to break down the barriers of communism. As a nurse on a medical surgical floor at a Baltimore city hospital, I was excited to do my part to improve my patients’ health through education and support, but I quickly learned that the real world of healthcare was very different than what I learned in nursing school. I saw the same patients continually readmitted and began to wonder what was going on in their communities. Who was managing these patients? Why were they coming back to the hospital with worsening conditions?Patient_2_jpg

I soon learned that these problems were a result of a fragmented and disparate healthcare system. It was all about volume versus value, with very little thought given to standards of care or outcomes.

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Topics: ACO, Healthcare Reform, PCMH, Patient-Centered Care, IDN, Population Health, PCSP, CIN, PHO, ICO

Pioneer ACOs: Looking Back on the First Year and Determining the Key to Future Success

Posted by Bruce Eckert, MBA, CPHIMS, FHIMSS, National Practice Director on Sep 18, 2013 2:58:00 AM

As a kid, growing up in the snowy northern U.S., I remember many happy afternoons sledding. After a good snow, all of the neighborhood kids would gather at “our” sledding hill. Someone always had to be the first down the hill, but no one liked to volunteer; that first trip down the hill was tough in fresh snow. Usually, the biggest kid went first, since it wasn’t so much sledding as plowing the path for the rest of us. But, once the trail was marked and packed, it was smooth going from there.

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Topics: ACO

Playing the ACO Symphony

Posted by Alan Cudney, RN, CPHQ, PMP, FACHE, Executive Consultant on Jun 11, 2012 2:30:00 PM

There’s a great line in the 1995 movie, Mr. Holland’s Opus. At the end of his career, Mr. Holland, a music teacher, feels dissatisfied that he was never able to complete his life’s dream of being a composer. One of his students tells him, “There is not a life in this room that you have not touched, and each of us is a better person because of you. We are your symphony, Mr. Holland. We are the melodies and the notes of your opus. We are the music of your life.” Done well, an ACO is like a symphony played for an audience of patients. All the moving parts come together to create something bigger than each individual piece.

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Topics: ACO


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