Recently, a healthsprocket list was posted displaying about six different requirements that an ACO must meet in order to be eligible for the ACO Investment Model. The list's origin comes from the Centers for Medicare and Medicaid Services website fact sheet during the month of October.

The requirements in order to be accepted are as follows: 1) Must be accepted into and participate in the Shared Savings Program. 2) Has completely and accurately reported quality measures to the Medicare Shared Savings Program. 3) Has a preliminary prospective beneficiary assignment of 10,000 or fewer beneficiaries for the most recent quarter. 4) Does not include a hospital as an ACO participant or an ACO provider/supplier unless the hospital is a (CAH) or (IPPS) hospital with 100 or fewer beds. 5) Is not owned or operated in whole or in part by a health plan. 6) Did not participate in the Advance Payment Model.

The goal of coordinated care is to make sure that patients get the right care at the right time, while avoiding duplication of services and preventing errors. ACOs represent one piece of a comprehensive series of initiatives in the Affordable Care Act that are created to decrease costs and increase the improvement of care. When there is success in both delivering high-quality care and spending health care dollars wisely, savings will be achieved for the Medicare program.

This week, a healthsprocket list was posted showing seven ways that predictive analytics can improve healthcare. The list comes from the Elsevier website and was written by Lina A. Winters-Miner, PhD.

Predictive medical analytics have the power to change healthcare on a global scale. There is a diagnoses increase due to predictive analytics. Secondly, it assists with preventive medicine and public health. Thirdly, predictive analytics give doctors the answers they require for patients. Fourthly, it can supply hospitals with predictions about insurance product cost(s). Fifthly, this type of analytic(s) allows researchers to create models that do not require thousands of cases. Sixthly, the best needs for public medication can be met in regards to the pharmaceutical companies. Finally, patients will receive the better benefit outcome thanks to predictive analytics.

Recently, a healthsprocket list was posted displaying five measures to cope with the side effects of health reform. The list comes from Pharma Exec and was written by Sydney Rubin. Sydney is a senior communications consultant with inVentiv Health. More than 8 million Americans signed up for health insurance through state health exchanges.

The five measures to be able to cope with the side effects of health reform are: (1) Reach out to patient groups and high-profile patient bloggers to begin discussion on patient perspectives, wants and needs. (2) Provide clear and compelling educational materials to organizations that help demonstrate a medicine’s value. (3) Where ACA safeguards are insufficient, product suppliers should consider advocating for additional state or federal policy interventions. (4) Assume that external and internal communications are visible to payers and make sure all communications around a drug’s value are consistent and aligned, inside the organization and out. (5) The Affordable Care Act has started to improve access to medical care for millions of people/patients. Unfortunately, the real impact of reform will not be known until we see how benefit designs affect access to health products, medicines, and services.

The exchanges have revealed what they have to offer and tradeoffs need to be made in order for patient care to realize moderate premiums under the Affordable Care Act. The time is now for patients/providers of products and services to make sure their voices are heard loud and clear.

ACO Excellence (5 Keys for Success)

Fri, 10/03/2014 - 17:06

This week, a healthsprocket list was posted showing five keys to ACO Excellence. The list comes from Becker's Hospital Review and was written by Karen Tomes, Vice President of Care Management and Coordination, Allina Health. Accountable care organizations are still learning how to survive and thrive in the newest healthcare marketplaces today.

Based on previous experiences, ACOs require tools to succeed. This includes (but not limited to) comprehensive EHR systems, and a method to identify patients who need specialized care. Also, data is needed to assist providers managing patient care, and networks that support the delivery of care and educational strategies for workforce development is essential. These five strategies are important, but there are many other ACOs that are implementing as they deliver their care to patients. This is based on increased value and results in lower costs with much better outcomes in the long run.

Recently, a healthsprocket list was posted showing four recommendations to improve the Medicare Advantage Star System. The list comes from a Health Affairs blog by Howard Weiss and Sara Pescatello. They talk about how the Medicare Advantage Star System has a disproportionate impact on MA plans that are focusing on low-income populations.

This week, a healthsprocket list was posted displaying eight different ways to successfully navigate this enrollment season. The list comes from an Aon Hewitt news release. Tips are shared to assist workers in their preparation for the upcoming enrollment season.

Recently, a healthsprocket list was posted displaying six ways to successfully drive an mHealth project. The list comes from a Healthcare Global article by Stephanie Ocano. She shares that technology integration within the healthcare sector has potential to go further in regards to public health services. 

This week, a healthsprocket list was posted displaying some mega trends with the potential to be able to transform healthcare in the United States. The list comes from a Forbes article by Robert Pearl, M.D., CEO of Permanente Medical Group, certified plastic/reconstructive surgeon, and Stanford University professor.

Recently, a healthsprocket list was posted showing six technological innovations that assist with making a connection between patients and providers. The list comes from Property Casualty 360 (A National Underwriter Website) article by Kimberly George, Senior Vice President, Senior Healthcare Advisor at Sedgwick.

This week, a healthsprocket list was posted displaying the bottom five providers in overall customer service for Medicare Advantage. The list is from a health pocket healthcare research infostat by Jesse Geneson, data researcher at HealthPocket, and Kev Coleman, Head of Research Data at HealthPocket. Their analysis involves the companies with the lowest customer service scores.