Accountable Care Organizations Archives - Page 5 of 8

A Three Pronged Approach to Organizational Analysis

2017-04-02T13:28:30-04:00By BHM Marketing|Accountable Care Organizations, Clinical Analysis, Financial Analysis, Managed Care, Medicare and Medicaid, Operational Analysis, Organizational Analysis, Readmissions, Services|

When was the last time your organization performed a SWOT analysis? If you aren’t familiar with SWOT (strengths, weaknesses, opportunities and threats) it’s a widely used strategy in many industries, not just healthcare, for identifying areas for improvement. You can break SWOT down even further: Strengths: What sets your hospital apart from all the rest? What can you offer that makes you competitive? Weaknesses: What puts your hospital and employees at a disadvantage compared to other hospitals? What of these factors can you change? Opportunities: How can you show your strengths to others? Threats: What could cause big trouble for your hospital or employees?

ACOs vs Bundled Payments – Can Either Save Healthcare?

2023-07-28T15:02:47-04:00By BHM Marketing|Accountable Care Organizations, Services|

Everyone in healthcare knows that something’s got to give - it’s not a matter of “if” but “when” - and to some extent, how? In the arena of change, two major payment players, ACOs and Bundled Payments, are fighting to become the savior of American healthcare. Chances are you’ve already heard plenty about the former; accountable care is the hot topic of the year. Not only has it made headlines, but it’s been the topic of industry wide webinars and education.

Will Medicare Cover Telehealth?

2017-04-02T13:28:30-04:00By BHM Marketing|Accountable Care Organizations, Services, Telehealth and Telemedicine|

No doubt that in the coming years, telehealth will become a fundamental part of how doctors diagnose and treat patients. Of major concern for both providers and patients is, if this new technology becomes commonplace, who will pay for it? Telehealth, like most medical interventions, isn’t cheap. In order to have computer systems that can be used for teleconferencing, as well as the HIPAA compliant programs for videos [editor’s note: of which Skype is not]. Then, of course, after the initial purchasing costs come the costs of implementation, the cost of training and the cost of ongoing maintenance of the programs and systems.

Don’t Like the Sound of ACOs? Here is an Alternative

2017-04-02T13:28:31-04:00By BHM Marketing|Accountable Care Organizations, Services|

Most experts agree that it’s still too early yet to know for sure if ACOs will succeed, but many who are poised for its failure have started designing alternatives. One of them seems a little counter-intuitive: Non-Payment.

5 Trends in Healthcare Reimbursement

2017-04-02T13:28:31-04:00By BHM Marketing|Accountable Care Organizations, Physician Compensation, Services|

The subject of physician compensation is a hot one as of late. With all the changes in the financial sector of healthcare, and the push to save money, there has likewise been a focus on how- and how much- physicians are being compensated. ACOs A major change that has already begun to take place in many healthcare systems nationwide is Accountable Care Organizations (ACOs). While it’s likely too soon to know if they will work long term, in theory they will reduce the tendency of ‘silos’ in healthcare and lead to better coordination of patient care.

Have ACOs Failed to Incentivize Providers?

2017-04-02T13:28:31-04:00By BHM Marketing|Accountable Care Organizations, Services|

Since there has been an ongoing and rather enormous shift away from fee-for-service models, payers are tasked now more than ever being with finding a place for financial incentives to continue with ACOs now in place. Payers know that medicine, like any business, is not immune to the pull of financial incentives. Providers, while they are noble in their careers as healers, are just as likely as a Wall Street banker to leap at the chance to accept a financial perk. Time is money in any industry, and perhaps medicine most of all.

Will Physicians Ever Embrace ACOs?

2017-04-02T13:28:31-04:00By BHM Marketing|Accountable Care Organizations, Services|

Healthcare is changing, there’s no question about it. The question of the hour, however, is are we ready for it? Healthcare providers know that they have to stay on top of the latest research regarding treatment and medical technology, and so to they must keep abreast of the changes in policy. Not only do the changes affect how they will ultimately practice medicine, but perhaps most pressing, how will they be compensated for it. Enter, accountable care. These provisions have created confusion in the healthcare arena in general but perhaps a large share of that burden is being borne by the providers themselves, who must not only embrace new treatments and meet the demand of patients who are more educated on their conditions than ever before - but all the while keep in mind that the way they will be paid for their efforts has evolved, too.

Is NCQA Accreditation Right for You?

2017-04-02T13:28:31-04:00By BHM Marketing|Accountable Care Organizations, Accreditation, Services|

In the alphabet soup of healthcare accreditation, chances are there are at least one or two accrediting bodies that you aren’t entirely sure about - one of those might be NCQA. Who are they, what do they accredit and do you need their accreditation in your organization? Who is NCQA? The National Committee for Quality Assurance is an independent, non-profit in the United States that is concerned with establishing quality standards for healthcare organizations that aim to identify key areas of improvement within the organizations themselves. NCQA was established in the early ‘90s, a time in United States healthcare where there was a discernible shift in healthcare reform throughout The Clinton Administration.

Managed Care Trends | Where Are We Headed?

2017-04-02T13:28:32-04:00By BHM Marketing|Accountable Care Organizations, Health Insurance, Managed Care|

Many people who talk about managed care don’t realize that it has actually been undergoing a bit of a renaissance since the late 1980s - and has existed conceptually since the ‘30s. Since the late ‘80s, MCOs have progressed through several phases: Phase 1: Using utilization review and pre-admission certification to manage access to care. Phase 2: The addition of fee-for-service networks and managing benefits. Phase 3: Shift from utilization review to utilization management with an emphasis on the ‘appropriateness’ of care as well as the care setting. Phase 4: The current phase of MCO development, which has only started in the last couple of years, looks at establishing a continuum of services, lessening the tendency for providers to operate in ‘silos’ which has been the dominant structure of healthcare in the U.S. for years.

What ACO Obstacles are You Facing?

2017-04-02T13:28:32-04:00By BHM Marketing|Accountable Care Organizations, Services|

While many have been quick to defend the slow rise of Accountable Care Organizations (ACOs), many others are looking not at the slowness of the climb, but the inconsistency. Circling back to the entire point of ACO formation in the U.S. there were two distinct motivations: 1) the care previously provided by independent physicians was more often than not uncoordinated and 2) the fee-for-service payment model was inefficient and made the incentive for physicians providing more care not necessarily good care.

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