Health care in America is undergoing great change. Soon, accountable care organizations'health care organizations that tie provider reimbursements to quality metrics and reductions in the cost of care'will be ubiquitous. But how do you set up an ACO? How does an ACO function? And what are the keys to creating a profitable ACO?
Pathways to a Successful Accountable Care Organization will help guide you through the complicated process of establishing and running an ACO. Peter A. Gross, MD, who has firsthand experience as the chairman of a successful ACO, breaks down how he did it and describes the pitfalls he discovered along the way. In-depth essays by a group of expert authors touch on
the essential ingredients of a successful ACO
monitoring and submitting GPRO quality measures
mastering your patients' responses to the Consumer Assessment of Health Plans Survey
how bundled payments and CPC+ can meld with your ACO
how MACRA and MIPS affect your ACO
the role of an ACO/CIN
the complexities of post-acute care
data analytics
engaging and integrating physician practices
and much more
Dr. Gross and his colleagues are in a perfect position to guide other health care leaders through the ACO process while also providing excellent case studies for policy professionals who are interested in how their work influences health care delivery. Readers will come away with the necessary knowledge to thrive and be rewarded with cost savings.
Contributors: Joshua Bennett, Allison Brennan, Glen Champlin, Kris Corwin, Guy D'Andrea, Joseph F. Damore, Mitchel Easton, Andy Edeburn, Seth Edwards, Jennifer Gasperini, Kris Gates, Shawn Griffin, Peter A. Gross, Brent Hardaway, Mark Hiller, Beth Ireton, Thomas Kloos, Jeremy Mathis, Miriam McKisic, Morey Menacker, Denise Patriaco, Elyse Pegler, John Pitsikoulis, Michael Schweitzer, Bryan F. Smith
AcknowledgmentsContributorsPreface1. Essential Ingredients of a Successful ACO, by Peter A. Gross2. Patient-Centered Medical Homes (PCMHs): A Key ACO Building Block, by Joshua Bennett3. Care Coordination: Initial Plans and Evolution, by Denise Patriaco4. Quality Measurement in Accountable Care Organizations, by Guy D'Andrea and Kris Corwin5. Monitoring and Submitting GPRO Quality Measures: CMS Web Interface, by Kris Gates6. Live Experience of a Quality Measure Validation (QMV) Audit, by Mitchel Easton7. Ready, Risk, Reward: Building Successful Two-Sided Risk Models, by Brent Hardaway, Elyse Pegler, and Bryan Smith8. Post-Acute Care (PAC): A Key Consideration for the ACO, by Andy Edeburn9. Data Analytics: Making A Choice, by Shawn Griffin10. Impact of Coding and Documentation on Risk Scores, by Glen Champlin and John Pitsikoulis11. Legal and Compliance Consideration, by Seth Edwards12. Employee Health Management and the Role of an ACO/CIN, by Jeremy Mathis13. The Role of Primary Care in the Future of Health Care, by Morey Menacker14. Practice Transformation: Engaging and Integrating Physician Practices, by Thomas Kloos15. Population Health Management Consulting, by Joseph Damore16. CPC+ (Comprehensive Primary Care Plus) Initiative, by Seth Edwards17. Keys to Success in Bundled Payments, by Mark Hiller, Beth Ireton, Miriam McKisic, and Mike Schweitzer18. The ACO Guide to MACRA, MIPS, and QPP, by Allison Brennan and Jennifer GasperiniIndex
This book can light the way for improved health and economic success.Richard Wenzel, MD, Virginia Commonwealth University Medical Center
