Summary: Accountable Care Organizations (ACOs) are gaining in popularity as a result of the ACA. BHM Healthcare Solutions, a healthcare management consulting firm, has a team of experts dedicated to providing assistance to organizations as they transition from a traditional fee-for-service model to an ACOs assisting in the critical transition to provide quality of care.
Accountable Care Organizations began forming in the last quarter of 2010. Growth has been steadily increasing with roughly 30-40 new ACOs forming each quarter. This trend continued to pick up pace with huge upswings in ACO creation occurring towards the end of 2012 and the end of 2013. This change was brought on, in part, by the nations new mindset of reform when it comes to healthcare and is an example of how organizations are experimenting with new healthcare models to rein in costs and create a sustainable, affordable healthcare system to serve all. After 3 years, a total of 606 ACOs have been formed, including both Medicare and Medicaid specialized organizations. Leading the pack by number of ACOs per state is California with 58, followed closely by Florida with 55. At the conclusion of 2013, ACOs are now in all states including the District of Columbia.
ACOs – A Shift in Mindset
The move toward ACOs is a result of the Affordable Care Act (ACA). The ACA is focused upon achieving better patient quality outcomes, in more efficient ways, while reducing healthcare costs. The ultimate goal and painful transition is from fee-for-service to fee-for-value, shifting from volume to value and quantity to quality. This shift requires organizations to change corporate culture, increase coordination of care, and embark on infrastructure changes, just to name a few. This change cannot happen overnight. As such, the ACA has provided stepping stones in the pursuit of pay-for-value in the form of new delivery systems such as bundled payments and Accountable Care Organizations. Implementing these new delivery systems can be very cumbersome.
Different Approaches to ACOs
There are many different ACO models, and nomenclatures. ACOs can take on different names in different states such as Coordinated Care Organizations (CCOs) or Care Coordination Entities (CCEs). Some states are piloting 3 year demonstrations, while others are making a more permanent transition. The approach to cost savings can also vary depending on the state. Some states are reimbursing based on quality measures while other states are reimbursing based on cost reduction, while others are using a combination approach.
BHM’s ACO Expertise
BHM Healthcare Solutions understands this shift in risk and how the ACA affects providers, payers, and government entities. No matter what stage your organization is in as it relates to ACOs from contemplation to implementation, BHM can provide assistance and make the transition much easier. BHM has assisted many organizations as they transform to both Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs). BHM’s ACO conversion services assist organizations in effectively and efficiently making the shift to Accountable Care with sustainable solutions that cushion the financial impact off conversion and work to maximize margin growth.
BHM is a healthcare management consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services ranging including healthcare transformation assistance, strategic planning and organizational analysis, accreditation consulting, financial consulting for healthcare, physician advisor/peer review, and organizational development.