Accountable Care

The nature of the risk under the CMS Pioneer ACO and Shared Savings programs is hard for providers to manage. But the Next Generation ACO program has changed the level of risk, offering providers a higher share of savings and new ways to limit unpredictable losses.

Before committing to partnerships within a parochial healthcare network, all the players must know the stakes, the options available and most importantly, the methodology for proceeding with a business model that is foreign to most provider organizations.

Patient engagement can ensure the delivery of patient- and family-centered care while bolstering the ability of accountable care organizations to meet quality and savings goals.

With the Oncology Care Model, participating practices will have their chemotherapy treatments tracked and measured for the necessity and outcome of the treatment, as well as the coordination of care that leads up to the cancer treatment.

Perhaps the biggest value-based challenge on the finance side is the lack of a single set of metrics by which to gauge quality.

The surge in accountable care organizations and other network affiliations between healthcare providers is spelling big financial opportunity for hospital vice presidents of network development, a position that experts say is key in connecting the clinical and the business side of a health network.

With so many organizations making up your accountable care organization, the need for a collaborative approach to supply chain purchasing is leading organizations to lean on analytics tools and new chains of communication to keep costs in check.

Chief financial officers must determine the best value-based care model for their healthcare organization, experts say.

Only 19 organizations remain in the Centers for Medicare and Medicaid innovation model program, but many have seen millions in savings.

The CMS Actuary said the program expansion would give MSSP participants the option of joining a Pioneer model ACO instead of graduating to a Track 2 model, which gives them more flexibility and a chance for deep savings if hospitals show strong quality.