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It is the importance of accountable care organizations (ACOs), as much as the uncertainty about their future, that makes the Second Edition of The ACO Handbook: A Guide to Accountable Care Organizations necessary for those grappling with the changes brought about by healthcare reform. The contributors to this handbook are among the best professionals in America today who are seriously considering what it will take to succeed under the new healthcare environment. Their astute observations about the legal issues, both novel and familiar, likely to be encountered by those contemplating ACO development will be useful to the reader no matter what role these organizations ultimately play in the reformed U.S. healthcare system.Since the passage of the Affordable Care Act, many health care opinion leaders have predicted that the ACO may be one of the most significant transformative aspects of health care reform. The ACA directed the Centers for Medicare & Medicaid Services to experiment with ways to employ high-performance provider organizations to deliver comprehensive care to a specific group of patients over an event, an episode, or a lifetime, while assuming responsibility for the clinical and financial outcomes of that care.This new health care delivery method will require a level of cooperation and joint decision making that has often been lacking in traditional health care organizations. AHLA is pleased to bring you this greatly expanded and comprehensive second edition of The ACO Handbook: A Guide to Accountable Care Organizations.The book analyzes various components of an optimized delivery system, and examines issues ranging from the financial aspects of ACOs to the unique nature of academic medical center, pediatric, and commercial ACOs.The eBook versions of this title feature links to Lexis Advance for further legal research options.
It is the importance of accountable care organizations (ACOs), as much as the uncertainty about their future, that makes the Second Edition of The ACO Handbook: A Guide to Accountable Care Organizations necessary for those grappling with the changes brought about by healthcare reform. The contributors to this handbook are among the best professionals in America today who are seriously considering what it will take to succeed under the new healthcare environment. Their astute observations about the legal issues, both novel and familiar, likely to be encountered by those contemplating ACO development will be useful to the reader no matter what role these organizations ultimately play in the reformed U.S. healthcare system.Since the passage of the Affordable Care Act, many health care opinion leaders have predicted that the ACO may be one of the most significant transformative aspects of health care reform. The ACA directed the Centers for Medicare & Medicaid Services to experiment with ways to employ high-performance provider organizations to deliver comprehensive care to a specific group of patients over an event, an episode, or a lifetime, while assuming responsibility for the clinical and financial outcomes of that care.This new health care delivery method will require a level of cooperation and joint decision making that has often been lacking in traditional health care organizations. AHLA is pleased to bring you this greatly expanded and comprehensive second edition of The ACO Handbook: A Guide to Accountable Care Organizations.The book analyzes various components of an optimized delivery system, and examines issues ranging from the financial aspects of ACOs to the unique nature of academic medical center, pediatric, and commercial ACOs.The eBook versions of this title feature links to Lexis Advance for further legal research options.
An overview of the rapidly growing field of ant colony optimization that describes theoretical findings, the major algorithms, and current applications. The complex social behaviors of ants have been much studied by science, and computer scientists are now finding that these behavior patterns can provide models for solving difficult combinatorial optimization problems. The attempt to develop algorithms inspired by one aspect of ant behavior, the ability to find what computer scientists would call shortest paths, has become the field of ant colony optimization (ACO), the most successful and widely recognized algorithmic technique based on ant behavior. This book presents an overview of this rapidly growing field, from its theoretical inception to practical applications, including descriptions of many available ACO algorithms and their uses. The book first describes the translation of observed ant behavior into working optimization algorithms. The ant colony metaheuristic is then introduced and viewed in the general context of combinatorial optimization. This is followed by a detailed description and guide to all major ACO algorithms and a report on current theoretical findings. The book surveys ACO applications now in use, including routing, assignment, scheduling, subset, machine learning, and bioinformatics problems. AntNet, an ACO algorithm designed for the network routing problem, is described in detail. The authors conclude by summarizing the progress in the field and outlining future research directions. Each chapter ends with bibliographic material, bullet points setting out important ideas covered in the chapter, and exercises. Ant Colony Optimization will be of interest to academic and industry researchers, graduate students, and practitioners who wish to learn how to implement ACO algorithms.
Is the ACO strategy right for your organization? Accountable Care Organizations will help you understand the ACO framework and assess your readiness to embark on an ACO strategy. This book provides the structural blueprints, management skills, and cultural tools necessary to implement a successful ACO. Practical advice is bolstered with real world examples of leading healthcare providers that are pioneers in the rapidly changing world of accountable care. This guidebook is designed to facilitate critical conversations and decisions at all stages of the ACO development journey. Explore processes and structures and learn how to implement pilots to shape your own ACO delivery model. Each chapter includes takeaway points and tailored action steps for: (1) organizations interested in exploring the ACO concept, (2) organizations taking the first steps towards an ACO model, and (3) organizations already moving full speed ahead. This book will help you answer these questions and more: What does it take to become an ACO? What steps and actions should your organization take to implement an ACO strategy? How can organizational culture support your move to accountable care? How can you build a business plan to support an ACO strategy? What information technology is needed to implement an ACO strategy? How can an merging ACO best negotiate with third-party payers?
Written by renowned author Catherine Mullahy, The Case Manager’s Handbook, Fifth Edition is the ultimate how-to guide for case managers. This practical resource helps case managers build fundamentals, study for the Certified Case Manager (CCM) exam, and most importantly, advance their careers after the exam. Written for all professionals in all practice settings in case management, it uses real-life examples and an easy-to-read, conversational style to examine the case management process while presenting practical procedural information. An excellent daily reference and training guide for new case managers and seasoned professionals in various setting, The Case Manager’s Handbook, Fifth Edition is the “go-to” resource for facing the day-to-day challenges of case management, especially as the nation navigates through the many changes introduced by the landmark Patient Protection and Affordable Care Act. Significantly updated and revised, it contains eight new chapters: * Hospital Case Management: Changing Roles and Transitions of Care * Patient Centered Medical Home, ACOs, Health Exchanges * Evidence-Based Practice * Public Sector Reimbursement * Predictive Modeling * Pain Management * Health Technology, Trends, and Implications for Case Managers * The Affordable Care Act of 2010: Implications for Case Managers Included with each new print book is an Access Code for a Navigate Companion Website for students with objectives, multiple choice questions, and bonus appendices.
The Essential Guide to Accountable Care Organizations: Challenges, Risks and Opportunities of the ACO Model answers key questions surrounding ACOs so that hospitals, PHOs, IPAs and other physician organizations, networks or group practices can weigh the merits now of creating an ACO and complete the necessary groundwork before CMS's ACO operation date of January 2012.
The Healthcare Executive's Guide to ACO Strategy The Healthcare Executive's Guide to ACO Strategy is the first comprehensive book dissecting the integral components of ACOs from physician, provider, and payer views, including analysis of the CMS final regulations. In the wake of healthcare reform, ACOs continue to emerge as the care delivery and reimbursement model of the future. Get the book that provides specifics on incorporating accountable care structure and strategy into your organization so you can enter the ACO era prepared and positioned to succeed. Get expert advice on ACOs and the elements for success, including how to: Participate in the CMS Shared Savings program Distinguish the various characteristics of an ACO and its operations Understand how ACO reimbursement structure will work Evaluate the process of forming an ACO-including the legal, financial, IT, and governance requirements Fulfill important quality measures for an ACO Reshape and refine hospital-physician alignment strategies Table of contents: Chapter 1: ACCOUNTABLE CARE ORGANIZATION OVERVIEW What Is an ACO? The Logic of ACOs Basic ACO Tenets Key Characteristics of Accountable Care Chapter 2: HOW WE GOT HERE A Look Back at the 1980s and '90s The Alternatives to HMOs Medicare Prospective Payment System Physician-hospital Organizations Chapter 3: WHAT WE ANTCIPATE ABOUT THE ACCOUNTABLE CARE CONCEPT Accountable Care Organizations Why ACOs? What Will an ACO Look Like? Structural Change Challenges of Collaboration Chapter 4: PHYSICIAN-HOSPITAL INTEGRATION ACOs as a Driver of Alignment Different Alignment Models Continuum of Care and Integration Chapter 5: COMPENSATION AND ANTICIPATED CHANGES Historical and Current Reimbursement Structures Proposed Reimbursement Structures Medical Home Payment Models Chapter 6: ARE YOU READY FOR AN ACO ENVIRONMENT? Organizational Assessment Financing: Startup and Ongoing Expenses Market Assessment Chapter 7: LEGAL CONSIDERATIONS Requirements Governance Antitrust Issues Stark Law and Anti-kickback Statute Chapter 8: THE CMS SHARED SAVINGS PROGRAM Program Overview Shared Savings Program Tracts Interim Payment Option Chapter 9: BENCHMARKS FOR SHARED SAVINGS PROGRAM Assignment of Beneficiaries Cost Benchmarks Review of the Norton Healthcare and Dartmouth-Hitchcock Health Care System ACOs Chapter 10: QUALITY MEASURES Benchmarks, Standardization, and Protocols Utilization of Evidence-based Medicine Measuring Outcomes Patient Compliance Chapter 11: THE ROLE OF INFORMATION TECHNOLOGY Technology Considerations Health IT Market as it Relates to ACOs Harmonizing the ACO through Connectivity Chapter 12: PATIENT-CENTERED MEDICAL HOMES How Consolidation Has Shaped the Future Positioning for an Evolving Healthcare System What is the Patient-Centered Medical Home? Comparing ACOs and Medical Homes Chapter 13: Where Do We Go From Here? Form Physicians-Hospital Alliances Partner in the Delivery of Quality and Cost-effective Medical Care Review Current Compensation and Reimbursement Models Recap of ACO Programs
Written by renowned author, Catherine Mullahy, The Case Manager’s Handbook, Fourth Edition, is the ultimate how-to guide for case managers. This practical resource helps case managers build fundamentals, study for the CCM exam, and most importantly, advance their careers after the exam. Using real-life examples and an easy-to-read, conversant style, this reference defines “Best in Class” case management, examines the case management process, and presents practical procedural information. It is an excellent daily reference and training resource for new case managers and seasoned professionals in various setting facing the day-to-day challenges of case management. Certain to become the “go to resource” resource that previous editions have, this Fourth Edition features updated and enhanced chapters, and brand new chapters covering such timely topics as: * Obesity – The New Epidemic * Our Nation’s Multiculturalism and Challenges to Case Managers * Health Literacy and Adherence Issues * Pharmaceuticals – The Ever-Evolving World * Our Aging Population, Medical Advancements and New Case Management Considerations * Direct to Consumer Community-Based Case Management * Continuum Concepts