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ACOsAccountable Care Organizations

Accountable Care Organizations are patient centered organizations. Their goal is to provide individual patients seamless high quality care by the providers [physicians] and suppliers of services [hospitals, HHA, SNF and physicians] working together.

When will ACOs begin operating?

The Accountable Care Organization initiative has already begun and was commenced in January 2012. This has led to practices, hospitals as well as insurance companies planning to join or form ACOs in the near future.

The Role of PCMH’s in an ACO

The recognition for Patient Centered Medical Homes (PCMH) is crucial and cannot be achieved without workflow transformation which ensures providers to deliver quality care by keeping their patients engaged and satisfied. Healthcare providers can effectively measure outcomes through the use of Health IT tools which document and archive patient visits. For Accountable Care, these components form the basic principles and are embedded within the measures for the first major ACO program.

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How CureMD Supports PCMH Standards

PCMH Standard Details ACO Component CureMD Solution
Continuity Patients can access routine or emergency care and clinical advice both during and after office hours Patient/caregiver experience CureMD EHR
CureMD Practice Management Software
CureMD Patient Portal
CureMD ACO Consultancy
Manage Patient Populations Collection of clinical and demographic data for population management
Patient risk factor is assessed and documented by the practice
Proactive reminders/alerts are used to identify patients
Preventive health
High-risk populations including diabetes, hypertension, heart failure, coronary heart disease, vascular disease)
CureMD EHR
CureMD Practice Management
Manage Care Identification of specific patients with conditions such as complex care needs, mental health or problems related to substance abuse.
The emphasis of care management is on pre-visit planning, patient progress assessment towards goals of treatment and their barriers.
Usage of e-prescriptions
Reconciliation of at-visit patient medications and post-hospitalization
Patient/caregiver experience CureMD EHR
CureMD Health Information Exchange
Self-care Support Assessment of how patients/families can self-manage care provision
Collaboration between practice and patients to develop self-care plan and the provision of useful resources.
Consultation with patients on healthy behaviors plus the provision of mental health/substance abuse treatment
Patient/caregiver experience CureMD EHR
CureMD Practice Management
CureMD Health Information Exchanges
CureMD Consulting Services
CureMD Patient Portal
CureMD Resources (White Papers, Webinars)
Coordinate Care Practice coordination and follow-ups on tests, referrals and care at other entities
Management of care transitions.
Patient/caregiver experience
Patient Safety/Care coordination
CureMD EHR
CureMD Patient Portal
CureConnect
Improve Performance Usage of performance and patient experience data and statistics for improved performance.
Tracking of utilization measures e.g., ER visits.
Identification of vulnerable populations.
Demonstration of improved performance.
High-risk populations including diabetes, hypertension, heart failure, coronary heart disease, vascular disease) CureMD EHR
CureMD Medical Billing Services

How would ACOs be paid?

With the traditional fee-for-service system, providers earn more by giving patients more tests and performing a higher number of procedures. Experts believe that since this increases costs, members of an ACO would be given incentives as an encouragement to lower down costs and meet quality standards with a focus on disease prevention.

Which services does CureMD provide regarding ACOs?

  • ACO Consultancy Services
  • Resources
  • Educational Webinars
  • Affiliations and Partnerships

In response to the need for a technology solution that provides payers, providers, and patients with the functionality and knowledge required to deliver on the ACO/PCMH model, we provide an exclusive ACO Consultancy in which one of our ACO experts will guide you through the ACO process.

By partnering with us, you will ensure that you get a product that is compliant with most of the measures that are required to fulfill the criteria for an Accountable Care Organization.

Requirements to be part of an ACO

As per the federal laws, four types of entities can become part of an ACO.

  1. ACO Professionals. For example, doctors of medicine or osteopathy, physician assistants, nurse practitioners, clinical nurse specialists in group practice arrangements.
  2. Networks of individual practices of ACO professionals.
  3. Partnerships or joint venture arrangements between hospitals and ACO professionals.
  4. Hospitals employing ACO professionals.

In addition to these, the Proposed Rule allows the following entities to be part of ACOs.

  1. Providers or suppliers specified under the Social Security Act (SSA) that are otherwise not ACO professionals or hospitals.
  2. Critical access hospitals that bill under Method II.

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ACO Support

CureMD Solutions Supporting Features
EHR CureMD EHR enables continuity of care management and information sharing across multiple platforms, systems and organizations.
Practice Management Solution Integrated access across patient demographics, scheduling, electronic billing, administrative/financial reporting and workflow management connects front and back office operations, eliminates reimbursement delays and communication barriers.
Electronic Medical Billing CureMD provides robust financial and administrative capabilities to help speed and improve revenue cycle management in physician practices, medical centers, hospitals and hospital networks.
Patient Portal Facilitating patients to securely request appointments and refills online, receive test results as they become available, update their health status, history, demographics and insurance information.
ACO Consultancy Premium ACO consultancy services for entities looking to join or form an ACO.
Lab Integration Electronically transmit lab orders, receive results and simplify decisions with automated billing, flagging, tracking and trending.
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