Benefits of ACOs to Both Patients and Providers
Summary: Accountable Care Organizations (ACOs) are gaining in popularity as a result of the Affordable Care Act. Have you considered the benefits of ACOs from both the patient and provider perspectives?
One of the goals of the Affordable Care Act (ACA) is to provide coordinated care which, in turn, increases quality and efficiency within the healthcare field, and reduces costs.
ACOs – What is an ACO?
ACOs are groups of providers which form an organization based upon the Medical Home (or PCMH) concept. The Medical Home places responsibility for the coordination of care with the primary physician. The primary care physician coordinates with other physicians and providers such as specialty physicians, laboratories and diagnostic imaging, providing a central point for the patient’s medical information.
How Are You Using Physician Data Mining?
The pay for performance model of payment has been the preference of health insurance companies for several decades. Previous models made it too easy for money to be paid for services that were not truly needed, were poorly documented or in some cases, were entirely fabricated for the purpose of payment. Pay for performance measures are meant to validate payments to physicians in accordance with The Affordable Care Act by using data mining techniques to keep tabs on physician costs.
Do Patient Satisfaction Surveys Help or Hurt Reimbursement?
The “patient is always right” model has been the primary driving force behind healthcare for the last several decades. But is this the right approach? Classifying patients as “customers” is a slippery slope. While you might be able to barter with a customer at a shop about the price of a necklace, should doctors ever barter with a patient about their treatment? What about when their patient satisfaction scores are drooping low?
The Cost of Resistance | Clinical Coding Optimization
Physician practices may be lagging behind hospitals when it comes to implementing coding software. The hesitation to do so is costing them not only efficiency in coding, but reimbursements withheld due to avoidable errors.
Understanding RVUs and Medicare Reimbursement
Summary: Do you understand Relative Value Units (RVUs) as they relate to Medicare reimbursement? Is your physician compensation model based upon RVUs or a derivative thereof?
What is an RVU?
RVU stands for Relative Value Unit and is currently used by Medicare to determine the amount of reimbursement to providers. RVUs are basically a way of standardizing and comparing service volumes across all continuums.