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Gauging the Accountable Care Readiness of Your Practice

May 09, 2013

Accountable Care Readiness or ACO is the concept of healthcare providers (medical groups, practices and hospitals) collaborating for bringing down care costs and improving healthcare quality for specific patient population.

It is most certainly the rising phenomenon in the exceedingly competitive healthcare industry. With government regulations, audit costs and increased coverage of Medicare and Medicaid like carriers, healthcare providers are sensing an exceeding need to partner and collaborate instead of blindly competing. However, when ACO partners successfully achieve their goals, they share cost savings but the risk of failure is also shared by partners. Therefore, it is very important for you to gauge the ACO readiness of your practice before participating in ACO collaboration with another provider or agency.

To assess the feasibility of your practice becoming an Accountable Care Organization, you must evaluate the following parameters –

  • Operations of your practice
    Whether the physicians in your practice are working on fee-for-volume principle or believe in high value-high quality healthcare; the difference can dramatically affect your Accountable care readiness. Even though in short term, fee-for-volume may be financially suiting your practice but in long term the entire healthcare industry is transitioning towards quality services. Thus, before entering into any partnership, you must analyze your operational practices and decide whether you will be able to evolve in a partnership.
  • Your risk appetite
    In addition to your operational practices, your experience with risk based contracts can also determine your ACO readiness. As an ACO participant, you not only cherish cost savings but share the risk involved as well. If the participating groups fail to control costs for improved healthcare services, then the losses are equally shared by all participants. If you are willing to enter into risk based partnerships without prior experience, then ACO type arrangements that carry less financial risk might be the place to begin.
  • Technical readiness of your practice
    EHR is a commonplace health record management practice adopted by medical practices, but utilization of EHR to mine data regarding patient information and deriving value out of it is relatively rare. Before accepting an ACO partnership, you must assess the technical know-how of your staff to merge the data easily into the ACA set-up, and the potential value and information that you can derive from your patient data and put it to use for curtailing costs and improving service quality.
  • Objectives and strategies of participating group or organization
    It is of utmost importance to thoroughly discuss objectives and strategies with the medical group, hospital or practice that may be your potential ACO partner. Similar goals and focus can improve your chances of a successful partnership and reduce the financial risk.
  • Industry scenario
    External factors are as important as factors internal to your practice. ACO is a rising concept and while you may choose to pass on ACO partnerships presently, with time it may become industry norm. Evolving healthcare sector regulations are encouraging ACO and ACO type arrangements. Therefore, it is better to make a smart decision by readying your practice for Accountable care.

Medicalbillersandcoder.com largest consortium of medical biller and coders serving over 30 specialties and all 50 US States in medical billing, also offers comprehensive service in gauging your Accountable care readiness. We help you analyze all internal and external factors pertaining to your practice, pivotal to the success of an ACO partnership; assisting you in making a smart and informed decision.


Category : Practice Administration