Are ACOs Just HMOs in Disguise?
When we talk about Accountable Care Organizations (ACOs) , a lot of people think that they are nothing more than a second try at the ol’ Health Maintenance Organizations (HMOs) of the late 80s. ACOs may have some things in common with HMOs, but when you look a little bit closer you’ll see that there are a few very distinct elements that differentiate them.
7 Ways to Reduce ER Admissions / Re-admissions
For many hospitals, the emergency room is the busiest place for both staff and patients. Overcrowding, long wait times and inefficient care plague a lot of U.S. hospitals and there is a growing need for solutions. Not only is the overutilization costing money, but it is affecting patient satisfaction scores, meaning that hospitals aren’t meeting their annual measures.
Of course, there are times in the life of any emergency room, when it’s unavoidably busy: during summer months, hospitals that are in prime vacation areas need to plan for an influx of one-time patients. In the event of a disaster or outbreak of communicable illnesses in a community, utilization of emergency room services are certain to skyrocket. But what about in general, when physicians find that they are treating patients who, ultimately, do not need emergency services – meaning that patients who do are left in a lurch?
3 Ways Providers Optimize the “Pay-for-Performance” Model of Care|Doctor’s Channel
As part of BHM’s new partnership with The Doctor’s Channel, Anthony Grimaldi, BHM’s Senior Vice President Provider/Hospital Division, speaks about optimizing Pay-for-Performance models in healthcare.
The Doctor’s Channel specializes in short, interesting video clips (generally 2 minutes or less) that educate doctors and other medical professionals on nearly any specialty imaginable. The vast video library also has many segments and series that are eligible for CME, making it an excellent resource for providers.
BHM Successfully Launches Successful Transition to ACO Webinar
BHM Healthcare Solutions hosted its initial webinar in their ACO series August 1, 2014 on Succeeding as an ACO: A Guide to Transforming Your Organization. Anthony Grimaldi, Senior Vice President of BHM’s Provider / Hospital Division and Gwen Roberts, Senior Vice President of BHM’s Government / Payer Division were the keynote speakers. They delivered a riveting presentation focusing on issues in which providers, payers, pharmaceutical companies and states need to be aware, address, and implement in order to successfully transform to an ACO, while remaining viable, profitable, and successful.
Top 7 Benefits of an External IRO | Why You Need an External IRO
With healthcare reform well under way, External Independent Review Organizations, (IROs) have become a requirement nationwide. For some, it’s a welcomed change to current strategies, but for other organizations, there might be a lot of unanswered questions about that transition, the motivation behind it and the necessity.
How Much are Your Denied Claims Costing You? | 4 Tips in Reducing Claim Denials
If you have a higher percentage of claim denials in your organization than you are comfortable with, you’re probably long over due for a close look at what is driving these denials up – and I hate to be the one to tell you, but it’s not the payers!
Top 4 Reasons Why Your Claims are Denied
Claims get denied for a variety of reasons – some of them are extremely simple to remedied, while others may require entire shifts in your organizational structure.
Understanding the Revenue Cycle
Understanding the revenue cycle can be tricky for many of us who work in healthcare. Unless we are directly involved with patient accounts, the subtleties of the process may be lost on us. That is, until we find ourselves patients – at which point even the most minute details of the process evident to us. If we want to get a clear view of the process in its entirety, and how we can improve at each step of the way, it’s often easiest to look at it as a continuous process which is always initiated by patient registration.
How Technology is Improving Independent Review Organization| The Doctor’s Channel
As part of BHM’s new partnership with The Doctor’s Channel, Mike Forrester, BHM’s Senior Vice President Independent Review Organization (IRO) Division, speaks about the amazing technology advancements that enable instant communication between clients, physician reviewers and BHM Healthcare Solutions.
You Can’t Always Get What You Want: The 3 C’s of Negotiation.
In a healthcare setting, perhaps nothing is more valuable to leaders than a keen eye for negotiation. Obviously, successful negotiation techniques are largely dependent on the situation – and in healthcare, those situations often times are not small potatoes. Often, it’s life or death.
ACO is Not One Size Fits All
A common misconception about ACO conversion is that there is a single method of planning and implementation that will work for all healthcare organizations. To dispel this belief is first and foremost in understanding the reality of ACO conversion for your organization.
As with most decisions related to healthcare, your organization wants to be sure that it is acting in line with your previously stated mission and values. It is through these two brief, but important, written declarations that you communicate with patients and earn their confidence. When you are considering ACO conversion, you should be sure that you are acting not only in the interest of the organization, but the population that you serve. In order to determine whether or not you are prepared for ACO conversion, you should weigh the pros and cons, not only for your staff, but for your patients as well.
