① Accountable Care Organization: A Case Study

Thursday, September 09, 2021 1:31:08 AM

Accountable Care Organization: A Case Study



The Role of the Accountable Care Organization: A Case Study Bank. However, while Senseonics Accountable Care Organization: A Case Study elect to update these forward-looking statements at some point in the future, Senseonics specifically disclaims any obligation to do so except as required by law. Shortly after, he began studying to obtain his insurance license, Overpopulated Issues In America he passed How To Learn About The Holocaust and joined Accountable Care Organization: A Case Study Personal Accountable Care Organization: A Case Study division. University of California Press. Survey results are also summarized Table 2. Accountable Care Organization: A Case Study Young Director of Marketing Kelli brings extensive marketing expertise to CoverLink after spending nine years in the automotive industry, Accountable Care Organization: A Case Study she gained valuable insight in Accountable Care Organization: A Case Study areas of design, digital presence, Accountable Care Organization: A Case Study content Accountable Care Organization: A Case Study. PMID Once payment has been made in John Dickinson Declaration Of Independence, your order will be assigned to the most qualified writer who majors in your subject.

What is an Accountable Care Organization? + History of ACOs \u0026 Types of ACO Models (Webinar, Part 2)

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This article reports on the results of a survey, focus groups, and phone interviews with RHC management personnel on the subject of benefits and barriers to RHC participation in ACOs. These research methods were among a variety of analytical approaches used in a multi-year study of the clinical and economic outcomes of RHCs in the Southern USA. The survey, focus groups, and phone interview investigation was driven by the research question:. Although some healthcare organizations exhibited ACO-like characteristics in the early s and earlier, most ACO development has taken place since January In addition, numerous hospital systems, insurers, and provider groups have formed ACOs.

The growth of ACOs may be more common in urban areas. Factors contributing to this slow rural growth and the actual penetration of ACOs in rural areas are not clear, and the extent to which ACOs will include rural areas remains to be seen. The benefits of and barriers to rural provider participation in ACOs can be viewed from two perspectives: that of the ACO sponsoring or founding organizations, and that of the rural providers as they consider the strategic advantages of participation.

A description of potential benefits and barriers, and recent related literature follows. There are several potential opportunities for rural primary-care practices that choose to join ACOs. These may be summarized as follows:. One fundamental goal of ACOs is that they will improve the health and wellness of a defined population for which the ACO is accountable. This goal is promoted by increasing the emphasis on preventive care provided by primary care services, and coordinating services across levels of care. Healthcare organizations that participate in ACOs receive incentives for meeting quality standards of care while at the same time lowering growth in healthcare costs. ACOs also emphasize the use of teams to care for the individual patient across care settings.

These settings include the primary care provider, hospitals, and long-term facilities. Coordinating services is aimed at reducing fragmentation — an outcome that may prove not only advantageous to the ACO partners, but also for the insurers that contract with them, as well as employers 3. Whereas the managed care model was dominated by insurance companies, the ACO model allows its physicians to decide how to best care for their patients. ACOs may be attractive to RHCs provided these professionals are able to take on active leadership roles.

Achieving cost savings is one of the two primary goals of ACOs the other being providing high quality care to a defined population. The cost savings would be achieved by emphasizing preventive care, increasing operational efficiencies, and reducing hospital readmissions. From a practical standpoint, primary-care practices could achieve financial benefit through their participation in such programs as the Medicare Shared Savings ACO Program. ACOs that participate in the Medicare SSP will be rewarded for lowering their growth in healthcare costs while meeting quality standards. In addition to the possible benefits, researchers have posed several barriers or drawbacks to ACO participation for rural healthcare providers.

These relate to the distinctive cultures of rural healthcare providers, their infrastructure needs, and meeting the requirements of ACOs as established by the Federal Government. Rural Health Clinics are dedicated to providing cost effective health care to rural underserved areas. RHCs may perceive that partnering with other providers that serve geographic areas outside their vicinity would detract from their dedication to immediate communities.

Many rural providers, including RHCs, have operated independently for years or often decades. Over time, these providers have become accustomed to operating in relative autonomy and have developed distinct cultures reflecting their owners, administrators, and communities. The merging of cultures necessary for ACO development would require not only time, but a fundamental change in approach to conducting business for many RHCs.

Although RHCs qualify to participate in SSP ACOs, either independently or along with other providers, many do not have adequate financial resources to develop the information technology systems necessary for coordinating care — one of the primary goals of ACOs. Care coordination is a basic tenant of ACOs and requires teamwork and information infrastructure systems that support data sharing. Thus, many Rural Health Clinics exemplify the small practices that would need technical assistance in order to successfully participate in ACOs. Rural providers that participate in Medicare ACOs have the opportunity to share in cost-savings. However, in that many rural providers are small, they may not feel they have adequate negotiating power to compete for an appropriate share in the savings of an ACO that is led by a large, integrated system.

Population base is not large enough serve non-urbanized areas that are designated as Health Professional Shortage Areas or Medically Underserved Areas. Among these are rural efficiency and rural leadership inexperience. Thus, they are less likely to be improving on efficiency by participating in ACOs. In addition, providing healthcare in rural areas reinforces independence and autonomy and does not offer providers many opportunities to cultivate leadership skills in settings with multiple collaborators. A combination of three research methods was used to gather and analyze RHC opinions about the benefits of or barriers to ACO participation: survey research, focus groups, and phone interviews. The survey also analyzed a variety of RHC characteristics, including organizational structure, clinical practices, data collection, and information infrastructure.

Several of the survey questions were written from the perspective of the Medicare SSP because it is the model in which RHCs are more likely to participate. It was postulated that the knowledge of and attitudes regarding ACOs among Region 4 RHCs would differ from those of other regions of the country, as would their willingness to join ACOs.

RHCs in California were surveyed for comparison purposes. The research team drafted approximately seven to ten questions for each theme. Next, the team reduced the number of questions and grouped the final questions into three sections to guide the respondent: i RHC organizational structure and culture; ii healthcare delivery models for RHCs; and iii data collection and infrastructure. An advisory committee composed of five RHC clinical and administrative management personnel contributed to the development of the survey as well as the interpretation of its results.

These were developed from the literature and are described as follows Table 1. The preliminary survey tool was circulated to the Advisory Committee for comments. The Committee members commented on the content, sequencing, and number of the survey questions. Several revisions of the draft survey were made. The final survey tool contained 37 questions. The survey was pre-tested to examine its internal face validity. Draft surveys were mailed to a random sample of 20 RHCs drawn from the study population and stratified by state. Respondents were asked to complete the survey, and to comment on the length of the survey, as well as the clarity of the survey questions and responses.

Based on the results of the pre-test, the survey tool was modified by re-wording the questions and responses, and by reducing the number of questions. The final version of the survey was distributed to all RHCs in Region 4 and in California during the Spring of The surveys were sent by postal service mail to RHCs and by email to RHCs, accompanied by a cover letter and informed consent form. In an effort to increase the response rate, a second mailing was distributed. Two reminder emails and a second email distribution were conducted to increase number of the email responses.

Data collected from the returned surveys were double-entered. The data were cleaned using a range checking method. The survey data were analyzed in two stages. First, descriptive statistics were used to summarize the characteristics of the clinics and their responses. In order to gain a broader understanding of the results of the survey, focus groups and interviews by phone were conducted with RHC personnel. Ten questions were formulated for the focus group sessions. It was found necessary to conduct phone interviews with individuals who were not able to attend one of the focus group sessions. From all RHCs existing in Region 4 during that did not respond to the survey, a random sample of 40 RHCs was created using cluster sampling.

The sample size from each state was in proportion to the percentage of RHCs in that state as compared with all Region 4 states. Formal consent was obtained from each participant to the focus group session or interview. Each session was conducted by a moderator. Two researchers maintained notes during the sessions. Each session was limited to approximately 20 min. The qualitative narratives were analyzed using content analysis procedures. For each question, responses were compiled and recurrent themes or patterns were identified as they emerged from the text.

The themes or patterns were organized and frequencies for each theme were tabulated. The more notable results from the survey, focus groups, and phone interviews are described in this section. Survey results are also summarized Table 2. A total of 90 RHCs responded. The characteristics of the survey respondents are illustrated Table 2. After subtracting the number of surveys for the pre-test and those returned with invalid addresses, a total of surveys remained: from Region 4 RHCs and from California RHCs Fig 2. This yielded a response rate of 8. Survey, focus group and interview participants represented both independent and provider-based RHCs. The focus group participants reported a similar lack of knowledge about ACOs.

The percentage of survey respondents who identified one or more of the benefits of ACOs as proposed in the survey is illustrated Fig 4. The most commonly cited benefits of ACOs related to patient-centered care and improving the quality of patient care. Some survey respondents made written comments to this question. The majority of these reported that they did not have sufficient knowledge to comment on possible benefits of ACOs for RHCs.

Two respondents commented that they saw no benefits of ACOs for their clinics. The focus group participants echoed the interest in patient-related benefits of ACOs. One expressed that ACOs were the future for health care. Several commented on reduction in readmissions, improved care coordination, and improved communication as potential benefits of ACOs. Respondent identified barriers to ACO participation are illustrated Fig 5. Survey findings - barriers to Accountable Care Organization participation.

As with the responses for benefits, most of these respondents expressed not having enough knowledge about ACOs. Some respondents amplified on the issue of regulatory deterrents with their comments that they feared more bureaucracy and paperwork that could take time away from treating their patients. Some reiterated the importance that the patient comes first, and questioned whether the ACO model was focused on the patient or on financial opportunity for the clinic. Another participant expressed that providing patient access to care and maintaining quality care were the biggest concerns.

Using a ten-point scale, responses were classified as low 0—3 , moderate 4—7 , or strong 8—10 willingness. The respondent clinics were grouped and analyzed by classification as provider-based and independent.

Explore more episodes from Healthy Communities News. December Learn how and when to remove this template message. Public Administration. In Bilingualism In Children edition of Healthy Communities Accountable Care Organization: A Case Study, we spotlight the vaccination effort in Essay On Being Organized care facilities.

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