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The Healthcare Executive's Guide to ACO Strategy, Second Edition Coker Group Max Reiboldt, CPA Ellis "Mac" Knight, MD The Healthcare Executive's Guide to ACO Strategy, Second Edition, provides healthcare leaders with new strategies and tools to implement and manage accountable care organizations (ACO). Based on the experiences of organizations that have started down the path of ACO development, the authors discuss what has and hasn't worked and share new strategies for organizations grappling with managing an ACO. Wherever an organization is on the timeline for structuring its alliances and addressing evolving reimbursement issues in the accountable care era, this book delivers valuable information to help healthcare executives meet their pending challenges. This resources offers: Discussion of all updated regulations pertaining to ACOs Academic and real-world examples of the evolution of the Pioneer program Explanation of a new approach to bedside care that moves from the volume/productivity model to a value-based model A physician's viewpoint on ACOs from author Ellis "Mac" Knight, MD A focus on taking ACOs from theory to practice in implementing a value-based model: Coker's "Care Process Design System" Analysis of what has and hasn't worked, based on real experience A chapter dedicated to the experiences of the Pioneer program Table of Contents Chapter 1: Accountable Care Organizations and Clinically Integrated Networks: An Overview Chapter 2: How We Got Here Chapter 3: What We Anticipate About Accountable Care Concept Chapter 4: Moving From a Structural Construct to a Functional Construct Chapter 5: Physician-Hospital Integration Chapter 6: Compensation and Anticipated Changes Chapter 7: Are You Ready for an ACO and CIN Environment? Chapter 8: Legal Considerations of ACOs and CINs Chapter 9: The Pioneer Program and Its Outcomes Chapter 10: The CMS Shared Savings Program Chapter 11: Benchmarks for CMS Shared Savings Program Chapter 12: Quality Measures Chapter 13: The Role of Information Technology Chapter 14: Patient-Centered Medical Homes Chapter 15: Where Do We Go From Here? Appendix A: Pilot Programs in Place Appendix B: SSP Participants by Region/State Appendix C: Glossary of Acronyms Who should read this book? Healthcare executives C-suite and other high level financial, administrative, and clinical leaders within a hospital setting and in large private practices Healthcare attorneys Medical Staff Quality/Patient Safety professionals
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
The Healthcare Executive's Guide to Physician-Hospital Alignment With millions of dollars riding on a hospital's quality and patient satisfaction scores, hospitals and physicians need to work together to succeed. But how best to align? The Healthcare Executive's Guide to Physician-Hospital Alignment is an essential resource to develop your own roadmap, overcome common roadblocks, and choose the right alignment model and strategies for each service line. This comprehensive look at the drivers of physician-hospital alignment will help you and your organization: Understand key drivers of alignment from the physician and hospital perspective Identify common roadblocks and challenges of various physician-hospital alignment strategies Examine alignment models Create alignment strategies based on service line Take a look at the table of contents: Introduction Chapter 1: Overview of Alignment Reasons for alignment Hospitals' interest in aligning with physicians Current trends Summary Chapter 2: Strength in Numbers and Other Alignment Benefits Strength in numbers' impact on health systems Strength in numbers' impact on physicians Strength in numbers' impact on patients Overarching pros and cons of alignment Summary Chapter 3: Impact of Healthcare Reform and New Structures on Alignment Accountable care organizations Patient-centered medical homes American Recovery and Reinvestment Act Patient Protection and Affordable Care Act Summary Chapter 4: Alignment Models Limited integration models Moderate integration models Full integration models Summary Chapter 5: Alignment Strategies Continuum of alignment strategies Employment as an alignment strategy Professional services agreements as an alignment strategy Other alignment strategies Summary Chapter 6: Physician Practice Perspective Security and stability Respect and appreciation Adequate market share Continuing education and training Participation in managed care plans Financial support and compensation Access to capital Work-life balance Summary Chapter 7: Hospital Perspective Quality care Satisfactory margins Market share Physician collaboration Partnership against the competition Positioning for the ACO criteria Decreased HIT costs and improved efficiencies The continual process--dealing with reality Summary Chapter 8: Compensation Strategies Limited integration strategies Moderate integration strategies Full integration strategies Summary Chapter 9: Legal and Regulatory Considerations Economic issues Structural issues Unwind mechanics Do your due diligence Summary Chapter 10: Financial Considerations Key terms Standard of value Valuation approaches Summary Chapter 11: Information Technology Driving forces for IT Clinical HIT integration Designing the model The economics of aligning The role of electronic health records Procuring alignment-enabling technology Summary Chapter 12: Alternatives to Physician Alignment Strategies Practice-based quality collaboratives/clinically integrated networks Quality collaboratives and clinically integrated networks within a physician-hospital alignment strategy How do quality collaboratives differ from clinically integrated networks? Summary Chapter 13: Mergers and Acquisitions Types of mergers Why merge? Merger process The four-stage process Summary Chapter 14: Comparative Case Studies: Real Life Alignment Experiences and Outcomes Case study #1: Multiple service locations as a driver for a global payment PSA Case study #2: Securing a primary care base through employment Case study #3: Selecting a full form of alignment for strategic partnership Case study #4: Using moderate forms of alignment to develop service line cohesion Case study #5: Utilizing "new" forms of employment Chapter 15: Where Do We Go From Here? Preparing for alignment through clinical integration Population health planning and management Behavioral adjustments Fiscal considerations Final takeaways
The Healthcare Executive's Guide to Physician-Hospital Alignment With millions of dollars riding on a hospital's quality and patient satisfaction scores, hospitals and physicians need to work together to succeed. But how best to align? "The Healthcare Executive's Guide to Physician-Hospital Alignment" is an essential resource to develop your own roadmap, overcome common roadblocks, and choose the right alignment model and strategies for each service line. This comprehensive look at the drivers of physician-hospital alignment will help you and your organization: Understand key drivers of alignment from the physician and hospital perspective Identify common roadblocks and challenges of various physician-hospital alignment strategies Examine alignment models Create alignment strategies based on service line Take a look at the table of contents: Introduction Chapter 1: Overview of Alignment Reasons for alignment Hospitals' interest in aligning with physicians Current trends Summary Chapter 2: Strength in Numbers and Other Alignment Benefits Strength in numbers' impact on health systems Strength in numbers' impact on physicians Strength in numbers' impact on patients Overarching pros and cons of alignment Summary Chapter 3: Impact of Healthcare Reform and New Structures on Alignment Accountable care organizations Patient-centered medical homes American Recovery and Reinvestment Act Patient Protection and Affordable Care Act Summary Chapter 4: Alignment Models Limited integration models Moderate integration models Full integration models Summary Chapter 5: Alignment Strategies Continuum of alignment strategies Employment as an alignment strategy Professional services agreements as an alignment strategy Other alignment strategies Summary Chapter 6: Physician Practice Perspective Security and stability Respect and appreciation Adequate market share Continuing education and training Participation in managed care plans Financial support and compensation Access to capital Work-life balance Summary Chapter 7: Hospital Perspective Quality care Satisfactory margins Market share Physician collaboration Partnership against the competition Positioning for the ACO criteria Decreased HIT costs and improved efficiencies The continual process--dealing with reality Summary Chapter 8: Compensation Strategies Limited integration strategies Moderate integration strategies Full integration strategies Summary Chapter 9: Legal and Regulatory Considerations Economic issues Structural issues Unwind mechanics Do your due diligence Summary Chapter 10: Financial Considerations Key terms Standard of value Valuation approaches Summary Chapter 11: Information Technology Driving forces for IT Clinical HIT integration Designing the model The economics of aligning The role of electronic health records Procuring alignment-enabling technology Summary Chapter 12: Alternatives to Physician Alignment Strategies Practice-based quality collaboratives/clinically integrated networks Quality collaboratives and clinically integrated networks within a physician-hospital alignment strategy How do quality collaboratives differ from clinically integrated networks? Summary Chapter 13: Mergers and Acquisitions Types of mergers Why merge? Merger process The four-stage process Summary Chapter 14: Comparative Case Studies: Real Life Alignment Experiences and Outcomes Case study #1: Multiple service locations as a driver for a global payment PSA Case study #2: Securing a primary care base through employment Case study #3: Selecting a full form of alignment for strategic partnership Case study #4: Using moderate forms of alignment to develop service line cohesion Case study #5: Utilizing "new" forms of employment Chapter 15: Where Do We Go From Here? Preparing for alignment through clinical integration Population health planning and management Behavioral adjustments Fiscal considerations Final takeaways
Disruptive change is now the norm for most industries and healthcare is no different. The healthcare industry is undergoing sweeping change. To emerge as winners hospital executives must increase their organizations’ speed and capacity for transformation and innovation. They should note though that despite the imperative and their desire to innovate their hospitals and the magnitude of the opportunity for innovators to both do good and do well, all too many efforts fail, losing billions of dollars along the way. The thesis of this book is that established hospitals and systems have every opportunity to not just survive but succeed in the future. But to achieve this they need to create a future proof approach to innovation that spans the gamut of having the right strategies in place to having the appropriate people, structures, systems and processes in place to drive organizational innovation. It is based on what big, established players are doing right in terms of innovation and the patterns that they exhibit that creates value across industries. It is difficult to single out one organization that has figured it all out but they are all characterized by having reinvented themselves over and over again.
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?
Hospitals and health systems are facing many challenges, including shrinking reimbursements and the need to improve patient safety and quality. A growing number of healthcare organizations are turning to the Lean management system as an alternative to traditional cost cutting and layoffs. "Kaizen," which is translated from Japanese as "good change"
Drawing on the expertise of decision-making professionals, leaders, and managers in health care organizations, Hospitals & Health Care Organizations: Management Strategies, Operational Techniques, Tools, Templates, and Case Studies addresses decreasing revenues, increasing costs, and growing consumer expectations in today’s increasingly competitive health care market. Offering practical experience and applied operating vision, the authors integrate Lean managerial applications, and regulatory perspectives with real-world case studies, models, reports, charts, tables, diagrams, and sample contracts. The result is an integration of post PP-ACA market competition insight with Lean management and operational strategies vital to all health care administrators, comptrollers, and physician executives. The text is divided into three sections: Managerial Fundamentals Policy and Procedures Strategies and Execution Using an engaging style, the book is filled with authoritative guidance, practical health care–centered discussions, templates, checklists, and clinical examples to provide you with the tools to build a clinically efficient system. Its wide-ranging coverage includes hard-to-find topics such as hospital inventory management, capital formation, and revenue cycle enhancement. Health care leadership, governance, and compliance practices like OSHA, HIPAA, Sarbanes–Oxley, and emerging ACO model policies are included. Health 2.0 information technologies, EMRs, CPOEs, and social media collaboration are also covered, as are 5S, Six Sigma, and other logistical enhancing flow-through principles. The result is a must-have, "how-to" book for all industry participants.