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Accountable Care Organizations  Applying Managed Care Business Practices
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Summary of ACO Requirements
Summary of ACO  Requirements Continued ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Critical Success Factors-   Applying Managed Care Practices ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Barriers to ACO Development ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Challenges for an ACO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organizational structure and alignment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organizational structure and alignment suggested structure Board of Directors Quality Review Committee Compensation Committee Finance &  Operations  Oversight Compliance  Committee Utilization  Management  Committee Provider and member/customer constituent representation Clinical representation Quality metrics and  peer review process Provider stakeholder Representation Shared savings allocation Provider and  member representation Program monitoring Provider and administrative Representation ACO budget vs actual Clinical representation Policy development and  outcomes review Patient/Customer Advisory Council
Financial Management, Operational Efficiencies and Health Information Technology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Financial Management, Operational Efficiencies and Health Information Technology Continued ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ACO Provider Delivery System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Partner Contract Structure- Business Alignment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Management = Medical Management and Disease Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Coordination of Care and Patient Outreach Programs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Coordination of Care and Patient Outreach Programs Continued ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IT Resource Needs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Self-assessment for ACO Shared Savings or Risk Programs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contact Us: For Detailed Consulting on ACO Development and Management ,[object Object],[object Object],[object Object],[object Object],ACO development and management is more detailed than the foregoing slides may indicate.  Providers interested in pursuing this initiative should consult with their legal counsel and tax advisors

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ACO Development

  • 1. Accountable Care Organizations Applying Managed Care Business Practices
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8. Organizational structure and alignment suggested structure Board of Directors Quality Review Committee Compensation Committee Finance & Operations Oversight Compliance Committee Utilization Management Committee Provider and member/customer constituent representation Clinical representation Quality metrics and peer review process Provider stakeholder Representation Shared savings allocation Provider and member representation Program monitoring Provider and administrative Representation ACO budget vs actual Clinical representation Policy development and outcomes review Patient/Customer Advisory Council
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
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  • 18.