MetroCare/HealthChoice Trilogy Clinically Integrated Network FAQs

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "MetroCare/HealthChoice Trilogy Clinically Integrated Network FAQs"

Transcription

1 MetroCare/HealthChoice Trilogy Clinically Integrated Network FAQs 1. What is clinical integration? Clinical integration is a new model for healthcare delivery that promotes collaboration among a community s independent providers to furnish high quality and lower cost care in a more efficient manner. Physicians, hospitals, and other providers share responsibility for, and information about, patients as they move from one setting to another over the entire course of their care. Working together, clinically integrated providers develop and implement evidence-based clinical protocols, focusing on delivery of preventive care and coordinated management of high-cost, high-risk patients. Utilizing shared information technology, these providers conduct ongoing clinical care reviews to identify opportunities for improvement and ensure adherence to protocols. While the antitrust laws generally prohibit joint contract negotiations among independent providers, those laws permit clinically integrated providers to engage in collective negotiations with health plans. Working together, these providers can more effectively compete for payer contracts because they demonstrate high quality and greater efficiency in care delivery. 2. What is a clinically integrated network, or CIN? A clinically integrated network is the infrastructure needed to support clinical integration among all physicians within a community. Our CIN network, MetroCare / HealthChoice Trilogy (Trilogy), has developed a governance structure through MetroCare Physicians, Methodist Le Bonheur Healthcare and HealthChoice. MetroCare will decide on clinical protocol development and implementation, performance measurement and enforcement, and formulas for rewarding physician performance. HealthChoice will identify, implement, and maintain supportive technologies (including data analytics); analyzing care processes to identify efficiencies; encouraging patient engagement; negotiating pay-for-performance payer contracts; and distributing incentive payments to members. While a hospital can provide administrative expertise for a CIN, the network s clinical leadership is led by physicians. Only physicians have the knowledge, skill, and experience needed to achieve improvements in clinical quality and efficiency. Unlike organizations such as integrated delivery networks (solely with hospital-employed physicians) and large multi-specialty physician practice groups, which base their clinical integration strategies on economic integration, a CIN respects and preserves the economic independence of its physician members. 3. Who governs Trilogy? Trilogy is a 50/50 collaborative effort between MetroCare Physicians clinically integrated physicians and Methodist Le Bonheur Healthcare in partnership with HealthChoice. 4. What are the key characteristics of Trilogy? Well-defined governance structure to promote organizational goals while protecting individual interests. Physician-led. Data driven. Relentless focus on improving the health of the population served. Adherence to evidence-based medicine guidelines and clinical protocols. 5. Why has interest in CINs grown so rapidly in the last several months? The healthcare payment and delivery system is undergoing fundamental changes. Currently, a provider is paid for the individual services furnished by that provider. Such volume-based reimbursement offers no economic incentive for providers to work together in providing patient care. However, payers now are shifting to value-based reimbursement, i.e., rewarding providers that deliver high quality care in an efficient manner. These include, for example, the Medicare Shared Savings Program, hospital physician value-based purchasing, and bundled payments. Commercial insurers, as well as employers, also are aggressively pursuing value-based purchasing arrangements. More and more payers are introducing pay-for-performance provisions in their standard provider agreements.

2 6. How is a CIN different from an accountable care organization (ACO)? The term clinically integrated network dates back to the mid-1990s, when the Department of Justice and the Federal Trade Commission first acknowledged independent providers working together to improve quality and efficiency could engage in joint payer negotiations. The term accountable care organization was first used about a decade later in reference to a group of providers that assumes responsibility to provide care for an assigned patient population. Typically, an ACO bears some financial risk associated with providing such care. Generally speaking, an ACO is a more formal arrangement, structured to satisfy specific payer requirements. For example, only an ACO that meets certain regulatory requirements is eligible to participate in the Medicare Shared Savings Program. A CIN may elect to form an ACO for purposes of contracting with a particular payer. That decision, however, may be deferred until the CIN is fully operational. 7. How do pay-for-quality contracts and shared savings programs work? Under a pay-for-quality contract (often referred to as a P4Q contract), an individual provider continues to submit claims and received fee-for-service reimbursement. If the provider achieves a certain goal specified in the contract, the provider receives an additional incentive payment. A P4Q contract may provide for a penalty if a provider fails to meet a specified target. The Medicare Physician Quality Reporting System ( PQRS ) is an example of a P4Q program. Under PQRS, a physician will receive a 0.5 percent bonus payment if he or she submits a report on specified quality measures in If, however, a physician does not submit such a report in 2013, that physician will be penalized 1.5 percent on Medicare payments in Many commercial payers are looking to include P4P provisions in their contracts with individual providers. Generally speaking, Trilogy can negotiate more favorable P4Q terms. Also, Health Choice and MetroCare support an infrastructure that enables its members to achieve P4Q measures. Under a shared savings program, a network of providers is eligible to receive a portion of a payer s savings generated by improved quality and efficiency. This is accomplished through a multi-step process: (1) The payer contracts for a specific patient population with the CIN, and these patients are attributed to a CIN provider, the patients primary care provider. (2) Providers in the CIN continue to receive fee-for-service reimbursement for all services, including services for patients in the assigned population. (3) Trilogy negotiates a benchmark rate based on the payer s historical cost of providing care for that population. (4) At the end of the year, the Trilogy and the payer calculates the actual cost of providing care for the contracted patient population. (This includes the costs of care furnished by providers not included in the CIN. Patients in the assigned population are not limited to providers in the CIN). (5) If the actual costs of care are less than the benchmark and if specified quality measures are met, the CIN will receive a portion of the savings. If those measures are not met, the payer will not share the savings with the CIN. (6) Under two-sided shared savings programs, the CIN is liable for a portion of the difference if the actual costs of care exceed the benchmark. (7) The CIN is responsible for deciding how the shared savings (or losses) are to be distributed among its members. MetroCare Physicians, Methodist Le Bonheur Healthcare and HealthChoice will collectively make this decision. Typically, a portion of any shared savings payment is retained by the CIN to pay its expenses. 8. Are there CINs in other communities that we can use as models for our network? There is much to be learned from providers in other communities that have formed CINs. Keep in mind, however, there are only a handful of CINs that have been operating for an extended period of time. Most CINs have commenced operations only recently. There are far more communities (like ours) still in the early stages of the process. There is no one size fits all solution for clinical integration. To be successful, Trilogy (our CIN) must fit within our community s culture and values. Thus, it is critical physicians have an active leadership role and that all providers have the opportunity to participate in this planning process. The engagement of and proactive partnership with physicians is essential to long-term success.

3 9. Have other CINs been successful in improving quality and efficiency in healthcare delivery while protecting physician incomes? Early adopters have achieved impressive results. For example, you can find success stories at Advocate Health Care in Chicago, Billings Clinic in Montana, and Mesa IPA in Grand Junction, Colorado. Advocate Health Care publishes an annual Value Report (available at which clearly demonstrates the value of a high functioning CIN to providers, payers, and patients. 10. What types of protocols have other CINs adopted? Typically, a CIN develops its initial set of protocols around delivery of preventive care and management of patients with chronic diseases (e.g., diabetes, COPD, asthma, heart failure). CINs have utilized well-recognized quality standards as a basis for protocol development including, for example, National Quality Forum-endorsed standards. Other sources include CMS Physician Quality Reporting System measures, the Medicare Shared Savings Program performance standards, and Stage 1 and 2 meaningful use quality reporting requirements. In the case of Trilogy, MetroCare Physicians Quality Enhancement Committee will utilize the aforementioned protocols and ultimately decide upon the applicable physician metrics and guidelines. 11. How do CINs generate cost savings? First, adherence to CIN - approved clinical protocols and sharing of patient data eliminates unnecessary and duplicative care. A greater emphasis on preventive services saves money by avoiding more expensive care down the line. Second, a physician participating in a CIN has access to the network s care coordination services for his or her patients. This includes transitional care management as well as complex care management. A transition of care program is a set of steps designed to ensure the coordination and continuity of healthcare as patients move from one setting to another. This can include helping with logistical arrangements, education of the patient and family, and coordination among the health professionals. These programs have proven successful in reducing cost by avoiding hospital readmissions and emergency room visits. A complex care management program focuses on a small number of high risk, high cost patients. Research indicates that in most communities, a small number of patients generate a high percent of the cost. By providing intensive, personalized support for these patients that addresses their medical and psychosocial needs, costs can be significantly reduced by avoiding unnecessary treatment, hospital admissions and Emergency room use. 12. What role does technology play in Trilogy? Trilogy will employ technological solutions in several ways to advance its goal of improved population health: (1) First, technology can assist a physician in adhering to clinical protocols, such as tracking whether a patient has received certain preventive services. (2) Second, reporting on quality measures to the Trilogy network (or to payers directly) may be accomplished using IT solutions. (3) Third, data analytics can identify those patients for whom certain interventions are appropriate, thus allowing providers to manage those patients more effectively. (4) Fourth, technology can assist Trilogy in tracking care costs to identify opportunities for improvement. (5) Fifth, electronic health information exchange permits Trilogy members to effectively coordinate patient care (especially for high-cost, high-risk patients), thus improving outcomes and reducing costs. (6) Sixth, patient and family member access to electronic records enables them to be more active and engaged participants in the care process. 13. What are the network participation requirements for Trilogy? Physicians are required to have access to high speed internet, utilize electronic claims processing, have and use an active address, participate in Trilogy information session conducted by MetroCare, complete MetroCare s online health literacy, healthcare economics and network update modules. MetroCare will add additional participation requirements over time with reasonable advance notice and reasonable assistance to satisfy the requirements.

4 14. What additional expectations will there be of me as a Trilogy member? Physicians agree to cooperate with and participate in Trilogy, and to share clinical information that is necessary to administer the Clinically Integrated Program. Physicians also agree to actively participate in Trilogy development by participating in committees, contributing to guideline and metrics development, reviewing compliance with the program and/or assisting with evaluation of technology solutions. They also agree to refer to MetroCare physicians who are participating in the Trilogy unless specific circumstances require referral outside the network. The purpose of this clause is to promote integrated and coordinated care through our accountable network 15. Do all the members of my group have to participate in Trilogy? Yes. Each practice (Tax ID) will sign a group agreement and individual physicians and non-physician providers within the group need to sign an individual practitioner participation joinder to the group agreement. The group will be responsible for its activity as well as the activity of the individual practitioners. 16. Can we opt out of certain Trilogy contracts? Not for commercial contracts. Unlike the messenger model, you and your entire group must participate in all the contracts with which Trilogy chooses to contract. Trilogy will only contract with plans that agree to utilize our clinical integration program and reimburse us favorably for the services that we provide. Exceptions include Medicare, Tenncare and Workers Comp contracts. 17. How does Trilogy make decisions? How do the interests of the hospital balance against those of the physicians? Trilogy s governance structure is physician-led and furthers its members common goals while protecting their individual interests. This is achieved through the selection of governing board members, balancing voting rights among participants, reserving certain fundamental decisions to the respective parties, delegating organizational functions through carefully drafted committee charters, and other organizational processes. In summer 2014 MetroCare Physicians and Methodist Le Bonheur Healthcare entered into a 50/50 CIN agreement via HealthChoice. MetroCare Physicians is the governing body for its clinically integrated physicians. 18. What services will the Trilogy provide to its physician members? The following is a non-exclusive list of services Trilogy and MetroCare Physicians provides for its members Keep in mind Trilogy does not necessarily have to provide all services directly; and may contract with third parties for specific services. Also, in the future, Trilogy may contract to provide services to third parties. This may be a way for Trilogy to generate revenue to support its operations. Support the implementation and use of the Vision Practice Support Tool, which provides member practices with population registries, performance metrics, and additional care information about their patients Support and implement evidence-based medicine practices and population health improvement strategies Provide data and analysis of cost and quality metrics for clinically integrated patients Provide chronic disease management programs, such as diabetes prevention and management, to clinically integrated patients Provide care management services for high acuity clinically integrated patients Provide transitional care management services for clinically integrated patients Pursue preferred network contracts with private payors and local employers Develop and pursue gain-sharing, shared savings, and other quality and efficiency programs with financial rewards for physicians Participate in Medicare Shared Savings Program Support primary care providers in achieving Patient-Centered Medical Home designation 19. How will Trilogy s operations be funded? Funding for Trilogy s operations is currently coming from the joint ventures two partners, Methodist Le Bonheur Healthcare and MetroCare Physicians. 20. Will Trilogy participation be open to all physicians? To ensure compliance with the antitrust laws, Trilogy participation is open to all MetroCare members and who maintain compliance with specified performance standards. Participation in Trilogy will be completely voluntary. A practice decision regarding participation will not impact his or her status as a member of MetroCare or the HealthChoice panel.

5 21. What will happen to my private practice if I join the Trilogy? The purpose of Trilogy is to create an infrastructure through which independent providers can work together to improve the quality and efficiency of care. A participating practice in Trilogy will continue to bill and collect for services under their existing payer and will remain responsible for their practice s operations. Trilogy will not purchase any physician practice. No physician will be employed by or have an independent contractor arrangement with the Trilogy as part of Trilogy participation. Other than claims data, participating physicians will not be required to share financial information with the Trilogy. (See data FAQ s) A physician s relationship with Trilogy is defined by the terms of the MetroCare Participating Group Agreement. A practice or its physicians cannot be required by Trilogy to do anything that is not specified in that agreement. Nor can the CIN take any action against a practice or its physicians that is not spelled out in that document. 22. What will happen to Trilogy participants who do not meet established standards? The implementation of clinical protocols and performance measures will be an ongoing process of education and continuous quality improvement. No provider will be expected to perform at a certain level without adequate support to achieve that goal. While the intent is to improve quality and outcome metrics, successful CINs demonstrate the will to cull an outlier if all attempts, such as peer review and education, fail. To protect individual s rights, the CIN may establish a review process to afford a physician the opportunity to challenge an adverse decision. No participant will be excluded based solely on subjective criteria. 23. Who will use Trilogy? We will initially start with marketing Trilogy to commercial health insurance carriers such as Cigna, BCBST and United who desire to offer the accountable care approach to their purchasers. If Trilogy decides to engage in contracts with Medicare or Tenncare in the future, then there will be an opt out provision for practitioners for these specific governmental plans only. 24. How will the Trilogy program continue to change over time? All Trilogy requirements regarding establishment of change to IT, payments, administrative burdens, quality metrics, performance goals or any other significant areas impacting physician practices will be made by the MetroCare Board after careful consideration, review and contemplation. No decisions can be made unilaterally by either partner. 25. I still have other questions. Who can answer them? Please visit or You may also contact Janie Jones, MetroCare Director Practice Support at

Transition Sleep Practice to Respond to ACO Challenges DUANE JOHNSON PHD KATHRYN HANSEN, BS, CPC REEGT SLEEP CENTER MANAGEMENT INSTITUTE

Transition Sleep Practice to Respond to ACO Challenges DUANE JOHNSON PHD KATHRYN HANSEN, BS, CPC REEGT SLEEP CENTER MANAGEMENT INSTITUTE Transition Sleep Practice to Respond to ACO Challenges DUANE JOHNSON PHD KATHRYN HANSEN, BS, CPC REEGT SLEEP CENTER MANAGEMENT INSTITUTE ACCOUNTABLE CARE ORGANIZATION (ACO) CARE INTEGRATION AND QUALITY

More information

IU Health Quality Partners

IU Health Quality Partners FREQUENTLY ASKED QUESTIONS 1) What is IU Health Quality Partners? It is a clinically integrated provider group; it is not a contracted health insurance plan network where physicians receive a set fee for

More information

ACOs: Impacting the Past, Present and Future State of Healthcare

ACOs: Impacting the Past, Present and Future State of Healthcare ACOs: Impacting the Past, Present and Future State of Healthcare Article By Alan Cudney, RN, CPHQ, PMP, FACHE, Executive Consultant October 2012 What are Accountable Care Organizations? Can they help us

More information

Frequently Asked Questions. Note that WellStar Clinical Partners (WCP) is the name for WellStar s clinically integrated organization.

Frequently Asked Questions. Note that WellStar Clinical Partners (WCP) is the name for WellStar s clinically integrated organization. Frequently Asked Questions Note that WellStar Clinical Partners (WCP) is the name for WellStar s clinically integrated organization. General Questions Q. What are the WCP Vision and Mission statements?

More information

Introduction to the GLPTN Program. Provider Office & Physician Organization Briefing

Introduction to the GLPTN Program. Provider Office & Physician Organization Briefing Introduction to the GLPTN Program Provider Office & Physician Organization Briefing What is the GLPTN? The GLPTN is one of 29 Practice Transformation Networks (PTNs) funded under the brand new CMS Transforming

More information

5 pillars of clinical integration

5 pillars of clinical integration REPRINT AUGUST 2012 Daniel M. Grauman Carole J. Graham Molly Martha Johnson healthcare financial management association hfma.org 5 pillars of clinical integration A healthcare organization s ability to

More information

Build a Clinically Integrated Network

Build a Clinically Integrated Network Build a Clinically Integrated Network Create a Sustainable Future For your PHO/IPA April 25, 2013 Our Speaker Lori Fox Ward, SVP Clinical Integration has worked with Valence Health since 1996. Lori oversees

More information

DRAFT NCMS POLICY (v. 7) Accountable Care Organizations

DRAFT NCMS POLICY (v. 7) Accountable Care Organizations DRAFT NCMS POLICY (v. 7) Accountable Care Organizations Background: Accountable Care Organizations (ACOs) are an emerging health care delivery model comprised of groups of providers that join together

More information

The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration

The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration Written by Daniel J. Marino, President & CEO, Health Directions November 14, 2012 Originally published by Becker

More information

Federal Health Care Reform: Implications for Hospital and Physician partnerships. Walter Kopp Medical Management Services

Federal Health Care Reform: Implications for Hospital and Physician partnerships. Walter Kopp Medical Management Services Federal Health Care Reform: Implications for Hospital and Physician partnerships Walter Kopp Medical Management Services Outline Overview of federal health reform legislation Implications for Care delivery

More information

Mount Sinai Care: A Medicare Shared Savings Program Primer. Brett Bernstein, MD, AGAF, FASGE Medical Director, Provider Partners of Mount Sinai IPA

Mount Sinai Care: A Medicare Shared Savings Program Primer. Brett Bernstein, MD, AGAF, FASGE Medical Director, Provider Partners of Mount Sinai IPA Mount Sinai Care: A Medicare Shared Savings Program Primer Brett Bernstein, MD, AGAF, FASGE Medical Director, Provider Partners of Mount Sinai IPA Mount Sinai Health System Network Mount Sinai Health System

More information

Legal Challenges and Concerns with Clinical Integration

Legal Challenges and Concerns with Clinical Integration Legal Challenges and Concerns with Clinical Integration By Edward Matto and Claire Turcotte, Bricker & Eckler LLP A clear goal of health reform is to foster greater integration and collaboration among

More information

Population Health Management Primer

Population Health Management Primer Population Health Management Primer A White Paper October 2014 Impact Advisors LLC 400 E. Diehl Road Suite 190 Naperville IL 60563 1-800- 680-7570 Impact- Advisors.com Table of Contents What Is Population

More information

LARGE SCALE NETWORKS NEXT WAVE OF CLINICAL INTEGRATION

LARGE SCALE NETWORKS NEXT WAVE OF CLINICAL INTEGRATION CENTER FOR INDUSTRY TRANSFORMATION MAY 2015 LARGE SCALE NETWORKS NEXT WAVE OF CLINICAL INTEGRATION Authors Michael Strilesky Principal, DHG Healthcare michael.strilesky@dhgllp.com DHG HEALTHCARE CENTER

More information

Utilizing Clinical Integration to Align Physicians and Increase Market Share

Utilizing Clinical Integration to Align Physicians and Increase Market Share Utilizing Clinical Integration to Align Physicians and Increase Market Share Timothy J. Quinn, MD & Daniel J. Marino DISCLAIMER: The views and opinions expressed in this presentation are those of the author

More information

Helping You Achieve Better Clinical and Financial Health

Helping You Achieve Better Clinical and Financial Health McKesson Business Performance Services Accountable Care Services Helping You Achieve Better Clinical and Financial Health 1 We recognized that fee-for-service would decrease and value-based care would

More information

RE: Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program

RE: Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS 1345 NC P.O. Box 8013 Baltimore, MD 21244 8013 RE: Medicare Program; Request for Information Regarding Accountable

More information

Physician Discovery Services Provide a Full Range of Physician Practice Solutions

Physician Discovery Services Provide a Full Range of Physician Practice Solutions Physician Discovery Services OUR SOLUTION Truven Health Physician Discovery Services experts provide insights into a hospital or health system s physician enterprise. With experience in physician assessment,

More information

Clinical Integration: A Road Map to Accountable Care

Clinical Integration: A Road Map to Accountable Care Clinical Integration: A Road Map to Accountable Care Jacqueline Matthews, RN, MS Senior Healthcare Transformation Director IBM Watson Health May 12, 2016 Housekeeping 1. Using the control panel - Use the

More information

Clinical Integration Network (CIN)

Clinical Integration Network (CIN) Clinical Integration Network (CIN) Frequently Asked Questions Q: What is clinical integration? A: Clinical integration is a structured collaboration between community and employed physicians and hospitals

More information

Pediatric Alliance: A New Solution Built on Familiar Values. Empowering physicians with an innovative pediatric Accountable Care Organization

Pediatric Alliance: A New Solution Built on Familiar Values. Empowering physicians with an innovative pediatric Accountable Care Organization Pediatric Alliance: A New Solution Built on Familiar Values Empowering physicians with an innovative pediatric Accountable Care Organization BEYOND THE TRADITIONAL MODEL OF CARE Children s Health SM Pediatric

More information

Accountable Care Organizations New Healthcare Opportunities for Employers

Accountable Care Organizations New Healthcare Opportunities for Employers Accountable Care Organizations New Healthcare Opportunities for Employers The ACO and Employer Opportunities Since the passage of the Patient Protection and Affordable Care Act (PPACA) in 2009, the marketplace

More information

How Health Reform Will Affect Health Care Quality and the Delivery of Services

How Health Reform Will Affect Health Care Quality and the Delivery of Services Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care

More information

KATHLEEN L. DEBRUHL & ASSOCIATES, L.L.C. 614 TCHOUPITOULAS STREET NEW ORLEANS, LOUISIANA 70130 504.522.4054 (OFFICE) 504.522.9049 (FAX) WWW.MD-LAW.

KATHLEEN L. DEBRUHL & ASSOCIATES, L.L.C. 614 TCHOUPITOULAS STREET NEW ORLEANS, LOUISIANA 70130 504.522.4054 (OFFICE) 504.522.9049 (FAX) WWW.MD-LAW. CMS RELEASES PROPOSED ACCOUNTABLE CARE ORGANIZATION REGULATIONS By: Kathleen L. DeBruhl, Esq. and Lindsey E. Surratt, Esq. On March 31, 2011, the Centers for Medicare and Medicaid Services ( CMS ) issued

More information

Program Description and FAQ s 2016 Medicare Shared Savings Program Year

Program Description and FAQ s 2016 Medicare Shared Savings Program Year and FAQ s 2016 Medicare Shared Savings Program Year Who is the National Rural Accountable Care Consortium? The National Rural Accountable Care Consortium was formed in 2013 to pool knowledge, patients,

More information

Accountable Care Organizations & Other Reimbursement Reforms: The Impact on Physician Practices

Accountable Care Organizations & Other Reimbursement Reforms: The Impact on Physician Practices Accountable Care Organizations & Other Reimbursement Reforms: The Impact on Physician Practices Martin Bienstock, Esq. Wilson Elser Martin.Bienstock@WilsonElser.com The New York Times Take... For the first

More information

Program Description and FAQ s 2016 Medicare Shared Savings Program Year

Program Description and FAQ s 2016 Medicare Shared Savings Program Year and FAQ s 2016 Medicare Shared Savings Program Year Who is the National Rural ACO? The National Rural ACO was formed in 2013 to pool knowledge, patients, and resources so that independent community health

More information

Physician Value-Based Payment Modifier How will the VBM Impact Your Practice?

Physician Value-Based Payment Modifier How will the VBM Impact Your Practice? Physician Value-Based Payment Modifier How will the VBM Impact Your Practice? What is the Value-Based Payment Modifier (VBM)? The VBM provides for differential payment to a physician or group of physicians

More information

Accountable Care Organizations 101. MultiCare Connected Care October 20 22, 2014

Accountable Care Organizations 101. MultiCare Connected Care October 20 22, 2014 Accountable Care Organizations 101 MultiCare Connected Care October 20 22, 2014 1 Objectives 1. Describe what an ACO is and why we believe developing an ACO is important 2. Describe examples of what integration

More information

Clinical Integration in Practice Case Study Allina Health

Clinical Integration in Practice Case Study Allina Health Clinical Integration in Practice Case Study Allina ealth The Second of Six Conference Calls for VA, Inc. Leading Constructive Change Boston Cleveland Dallas Denver Miami San Francisco Washington, D.C.

More information

MACRA MIPS and CME. Working Group 3/17/16

MACRA MIPS and CME. Working Group 3/17/16 MACRA MIPS and CME Working Group 3/17/16 MACRA, MIPS and CME Enacted in April 2015 Eliminates SGR; Requires EHR interoperability by 2018 Creates Two New Payment Paths for Medicare Eligible Provider Reimbursement

More information

Accountable Care Organizations. Rick Shinto, MD Aveta Health Inc. July 20, 2010

Accountable Care Organizations. Rick Shinto, MD Aveta Health Inc. July 20, 2010 Accountable Care Organizations Rick Shinto, MD Aveta Health Inc. July 20, 2010 1 Health Care Reform- New Models of Care Patient Protection and Affordable care Act (PPACA 2010) controlling costs and improving

More information

CLINICAL INTEGRATION: A PHYSICIAN-LED PATH TO VALUE JUNE 7, 2016 WILLIAM J. MAYER, M.D., M.P.H., PRESIDENT AND CEO FEDERATION CARE NETWORK

CLINICAL INTEGRATION: A PHYSICIAN-LED PATH TO VALUE JUNE 7, 2016 WILLIAM J. MAYER, M.D., M.P.H., PRESIDENT AND CEO FEDERATION CARE NETWORK CLINICAL INTEGRATION: A PHYSICIAN-LED PATH TO VALUE JUNE 7, 2016 WILLIAM J. MAYER, M.D., M.P.H., PRESIDENT AND CEO FEDERATION CARE NETWORK OBJECTIVES UNDERSTAND CLINICALLY INTEGRATED NETWORK (CIN) APPROACH

More information

Healthcare Reform Update Conference Call VI

Healthcare Reform Update Conference Call VI Healthcare Reform Update Conference Call VI Sponsored by the Healthcare Reform Educational Task Force October 9, 2009 2:00-2:45 2:45 pm Eastern Healthcare Delivery System Reform Provisions in America s

More information

2010 MHA Governance Leadership Forum: Accountable Care Organizations. Chris Rossman, Esq. Foley & Lardner LLP Detroit, Michigan

2010 MHA Governance Leadership Forum: Accountable Care Organizations. Chris Rossman, Esq. Foley & Lardner LLP Detroit, Michigan 2010 MHA Governance Leadership Forum: Accountable Care Organizations Chris Rossman, Esq. Foley & Lardner LLP Detroit, Michigan Overview Major health care payment reform under the Affordable Care Act (

More information

CHAPTER 114. AN ACT establishing a Medicaid Accountable Care Organization Demonstration Project and supplementing Title 30 of the Revised Statutes.

CHAPTER 114. AN ACT establishing a Medicaid Accountable Care Organization Demonstration Project and supplementing Title 30 of the Revised Statutes. CHAPTER 114 AN ACT establishing a Medicaid Accountable Care Organization Demonstration Project and supplementing Title 30 of the Revised Statutes. BE IT ENACTED by the Senate and General Assembly of the

More information

Accountable Care Fundamentals for Medical Practice Executives

Accountable Care Fundamentals for Medical Practice Executives Accountable Care Fundamentals for Medical Practice Executives Nathan Anspach, FACMPE Senior Vice President and Chief Executive Officer John C. Lincoln Accountable Care Organization and John C. Lincoln

More information

Accelerating Clinical Integration

Accelerating Clinical Integration Accelerating Clinical Integration A collaborative white paper written by: Kenneth H. Cohn, MD, MBA, FACS, CEO of Healthcare Collaboration Peter A. Pavarini, J.D., partner at Squire Sanders (US) LLP, Executive

More information

Alternative Payment Models Impacting Care Delivery Across the Care Continuum

Alternative Payment Models Impacting Care Delivery Across the Care Continuum Alternative Payment Models Impacting Care Delivery Across the Care Continuum AT A GLANCE Contributing Tenant Partners The recent announcement by HHS and CMS accelerates the movement away from FFS and provides

More information

Crowe Healthcare Webinar Series

Crowe Healthcare Webinar Series New Payment Models Crowe Healthcare Webinar Series Audit Tax Advisory Risk Performance 2014 Crowe Horwath LLP Agenda Bundled Care for Payment Improvements Payment Models Accountable Care Organizations

More information

Population Health Management: Advancing Your Position in the Journey to Value-Based Care

Population Health Management: Advancing Your Position in the Journey to Value-Based Care Population Health Management: Advancing Your Position in the Journey to Value-Based Care Webcast Session One: An Integrated Approach to Population Health Management 11 August 2015 Welcome & Introductions

More information

Master of Health Administration

Master of Health Administration Master of Health Administration THE IMPACT OF CLINICAL INTEGRATION ON JOINT MANAGED CARE CONTRACTING AMONG INDEPENDENT PHYSICIANS MARC MERTZ Executive Master of Health Administration Candidate, 2011 University

More information

An Overview of Clinical Integration, ACOs and Risk Contracting

An Overview of Clinical Integration, ACOs and Risk Contracting An Overview of Clinical Integration, ACOs and Risk Contracting November 9, 2012 Todd Fitz Vice President Strategic Advisory Services Agenda Review factors driving evolution toward value-based care Outline

More information

The Cornerstones of Accountable Care ACO

The Cornerstones of Accountable Care ACO The Cornerstones of Accountable Care Clinical Integration Care Coordination ACO Information Technology Financial Management The Accountable Care Organization is emerging as an important care delivery and

More information

Proven Innovations in Primary Care Practice

Proven Innovations in Primary Care Practice Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare

More information

Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations

Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations Presented to The American College of Cardiology October 27, 2012 1 Franciscan Alliance Overview Franciscan

More information

Provider Participation in ACOs May Hinge on HHS Regulations

Provider Participation in ACOs May Hinge on HHS Regulations Source: Health Law Reporter: News Archive > 2010 > 04/15/2010 > BNA Insights > Provider Participation in ACOs May Hinge on HHS Regulations Provider Participation in ACOs May Hinge on HHS Regulations 19

More information

1 HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

1 HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Comments on Framework for Reform of Sustainable Growth Rate To House Energy & Commerce Committee And House Ways & Means Committee By National Committee for Quality Assurance Chairman Upton, Chairman Camp,

More information

Accountable Care Organization Workgroup Glossary

Accountable Care Organization Workgroup Glossary Accountable Care Organization Workgroup Glossary Accountable care organization (ACO) a group of coordinated health care providers that care for all or some of the health care needs of a defined population.

More information

What is an Accountable Care Organization. Amit Rastogi, MD President/CEO PriMed

What is an Accountable Care Organization. Amit Rastogi, MD President/CEO PriMed What is an Accountable Care Organization Amit Rastogi, MD President/CEO PriMed Goals Why is U.S. healthcare undergoing dramatic change How reimbursement structures are likely to change What is the timeline

More information

Legal Issues for Accountable Care Organizations

Legal Issues for Accountable Care Organizations Legal Issues for Accountable Care Organizations Health Care Reform Strategies Bruce Merlin Fried, Esq. ACO Summit June 7, 2010 ACOs in PPACA The Basics Section 3022 of the Protection and Affordable Care

More information

EXECUTIVE SUMMARY. June 2010. Pathways for Physician Success Under Healthcare Payment and Delivery Reforms. Harold D. Miller

EXECUTIVE SUMMARY. June 2010. Pathways for Physician Success Under Healthcare Payment and Delivery Reforms. Harold D. Miller EXECUTIVE SUMMARY June 2010 Pathways for Physician Success Under Healthcare Payment and Delivery Reforms Harold D. Miller PATHWAYS FOR PHYSICIAN SUCCESS UNDER HEALTHCARE PAYMENT AND DELIVERY REFORMS Harold

More information

Welcome to the First Edition!

Welcome to the First Edition! Issue #1/Dec. 6, 2010 Welcome to the First Edition! CHCA is pleased to welcome and introduce you to this first edition of the ACO Update newsletter. The newsletter is in response to numerous questions

More information

CMS-CMMI Releases Enhanced Medication Therapy Management (MTM) Model Test Beginning in January 2017

CMS-CMMI Releases Enhanced Medication Therapy Management (MTM) Model Test Beginning in January 2017 October 5, 2015 www.amcp.org CMS-CMMI Releases Enhanced Medication Therapy Management (MTM) Model Test Beginning in January 2017 Pursuant to a memorandum issued on September 28, 2015, the Centers for Medicare

More information

Meeting of the Advisory Panel on Outreach and Education (APOE) Centers for Medicare and Medicaid Services March 27, 2013.

Meeting of the Advisory Panel on Outreach and Education (APOE) Centers for Medicare and Medicaid Services March 27, 2013. 701 Pennsylvania Avenue, Ste. 800 Washington, DC 20004 2654 Tel: 202 783 8700 Fax: 202 783 8750 www.advamed.org Meeting of the Advisory Panel on Outreach and Education (APOE) Centers for Medicare and Medicaid

More information

CMS proposed rule on ACOs: http://www.gpo.gov/fdsys/pkg/fr-2011-04-07/pdf/2011-7880.pdf

CMS proposed rule on ACOs: http://www.gpo.gov/fdsys/pkg/fr-2011-04-07/pdf/2011-7880.pdf April 7, 2011 Dear Physician Colleague: On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) issued its long awaited proposed regulations on the Medicare Shared Savings/Accountable Care

More information

MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D.

MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D. MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D. November, 2012 Accountable Care Organization An ACO is a group of health care providers who agree to take on a shared

More information

CLINICALLY INTEGRATED NETWORKS: WHO, WHAT, WHEN, WHERE, WHY, AND HOW?

CLINICALLY INTEGRATED NETWORKS: WHO, WHAT, WHEN, WHERE, WHY, AND HOW? CLINICALLY INTEGRATED NETWORKS: WHO, WHAT, WHEN, WHERE, WHY, AND HOW? WHAT IS CLINICAL INTEGRATION? Clinical integration is a new model for health care delivery. The model promotes collaboration among

More information

/10/2015. Perspective. Payer Common Themes. MACRA Payment Reform. MIPS or APM? Summary

/10/2015. Perspective. Payer Common Themes. MACRA Payment Reform. MIPS or APM? Summary Looking Ahead: Value Based Reimbursement Considerations for the Medical Practice Kentucky MGMA Doral Jacobsen Senior Manager DHG Healthcare Kathy Rhodes Manager DHG Healthcare 1 Agenda 1. 2. 3. 4. 5. Perspective

More information

ACOs: Six Things Specialty Practices Should Know

ACOs: Six Things Specialty Practices Should Know ACOs: Six Things Specialty Practices Should Know =TOS Newsletter, July/August 2014= Authors: John P. Schmitt, Ph.D. and J. Garrett Schmitt, MBA, PCMH CCE INTRODUCTION Do you remember the analogy of four

More information

Medicare Value Partners

Medicare Value Partners Medicare Value Partners Medicare Shared Savings ACO Program Frequently Asked Questions (FAQ) Q: What exactly is a Medicare Shared Savings Program ACO? A: Medicare Shared Savings Program accountable care

More information

The Accountable Care Organization

The Accountable Care Organization The Accountable Care Organization Kim Harvey Looney kim.looney@ 615-850-8722 3968555 1 ACOs: Will I Know One When I See One? Relatively New Concept Derived from Various Demonstration Programs No Set Structure

More information

E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences

E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences Accountable Care Organizations and You E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences CEO, OSU Faculty Group Practice Chair, Department of Surgery Ohio State University

More information

ACCOUNTABLE CARE ORGANIZATIONS. Staff Attorney Legislative Council Service August 17, 2011

ACCOUNTABLE CARE ORGANIZATIONS. Staff Attorney Legislative Council Service August 17, 2011 ACCOUNTABLE CARE ORGANIZATIONS OVERVIEW Michael Hely Staff Attorney Legislative Council Service August 17, 2011 What is an Accountable Care Organization (ACO)? No set definition. National Conference of

More information

Incorporating New Payment Models Into a Managed Care Environment

Incorporating New Payment Models Into a Managed Care Environment Incorporating New Payment Models Into a Managed Care Environment Association of Community Affiliated Health Plans CEO Summit, Washington DC, July 13, 2011 Topics for our conversation today An experience

More information

July 20, 2015. Dear Colleague:

July 20, 2015. Dear Colleague: July 20, 2015 Dear Colleague: On May 29, 2015, the Department of Human Services released a request for information (RFI) to help guide us as we plan for the release of a new procurement for the provision

More information

Accountable Care Organizations (ACO) Proposed Rule Summary March 31, 2011

Accountable Care Organizations (ACO) Proposed Rule Summary March 31, 2011 Accountable Care Organizations (ACO) Proposed Rule Summary March 31, 2011 On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) released the longawaited proposed rule on Accountable Care

More information

Finalized Changes to the Medicare Shared Savings Program

Finalized Changes to the Medicare Shared Savings Program Finalized Changes to the Medicare Shared Savings Program Background: On June 4, 2015, the Centers for Medicare and Medicaid (CMS) issued a final rule that updates implementing regulations for the Medicare

More information

Using Partial Capitation as an Alternative to Shared Savings to Support Accountable Care Organizations in Medicare

Using Partial Capitation as an Alternative to Shared Savings to Support Accountable Care Organizations in Medicare December 2010 Using Partial Capitation as an Alternative to Shared Savings to Support Accountable Care Organizations in Medicare CONTENTS Background... 2 Problems with the Shared Savings Model... 2 How

More information

Transitioning to a Sub-Capitation (At Risk) Model

Transitioning to a Sub-Capitation (At Risk) Model Transitioning to a Sub-Capitation (At Risk) Model Presentation Overview Understanding the Changing Environment Understanding Changing Payment Models Network Management Keys For Success Shifting Mindsets

More information

Survey of Connecticut Accountable Care Organizations

Survey of Connecticut Accountable Care Organizations March 2016 Survey of Connecticut Accountable Care Organizations Accountable Care Organizations (ACOs) are a relatively new health care delivery structure serving Connecticut residents. ACOs are voluntary

More information

Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2

Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2 The American Medical Association and over 750 national and state-based physician and specialty organizations have gone on record in support of

More information

THE ACCOUNTABLE CARE ORGANIZATION (ACO) TRAIN IS LEAVING THE STATION: ARE YOU ON BOARD?

THE ACCOUNTABLE CARE ORGANIZATION (ACO) TRAIN IS LEAVING THE STATION: ARE YOU ON BOARD? UNDER THE MICROSCOPE NOVEMBER 5, 2013 THE ACCOUNTABLE CARE ORGANIZATION (ACO) TRAIN IS LEAVING THE STATION: ARE YOU ON BOARD? ISSUE. A 2006 Institute of Medicine report ( Performance measurement: Accelerating

More information

ACO s as Private Label Insurance Products

ACO s as Private Label Insurance Products ACO s as Private Label Insurance Products Creating Value for Plan Sponsors Continuing Education: November 19, 2013 Clarence Williams Vice President Client Strategy Accountable Care Solutions Today s discussion

More information

3M s unique solution for value-based health care

3M s unique solution for value-based health care A quick guide to 3M s unique solution for value-based health care Volume-based health care Part 1: Helping your organization navigate the journey from volume- to value-based health care. Value-based health

More information

ACOs ECONOMIC CREDENTIALING BUNDLING OF PAYMENTS

ACOs ECONOMIC CREDENTIALING BUNDLING OF PAYMENTS ACOs ECONOMIC CREDENTIALING BUNDLING OF PAYMENTS There are a number of medical economic issues Headache Medicine Physicians should be familiar with as we enter a new era of healthcare reform. Although

More information

STRATEGIC INNOVATIONS FOR AFFORDABLE, SUSTAINABLE HEALTH CARE:

STRATEGIC INNOVATIONS FOR AFFORDABLE, SUSTAINABLE HEALTH CARE: January 2011 STRATEGIC INNOVATIONS FOR AFFORDABLE, SUSTAINABLE HEALTH CARE: A Model for Health System Reform Environmental Scan Accountable Care Organizations Table of Contents ACCOUNTABLE CARE ORGANIZATIONS...

More information

Modern care management

Modern care management The care management challenge Health plans and care providers spend billions of dollars annually on care management with the expectation of better utilization management and cost control. That expectation

More information

Post-Acute/Long- Term Care Planning for Accountable Care Organizations

Post-Acute/Long- Term Care Planning for Accountable Care Organizations White Paper Post-Acute/Long- Term Care Planning for Accountable Care Organizations SCORE A Model for Using Incremental Strategic Positioning as a Planning Tool for Participation in Future Healthcare Integrated

More information

DETAILED SUMMARY--MEDCIARE SHARED SAVINGS/ACCOUNTABLE CARE ORGANIZATION (ACO) PROGRAM

DETAILED SUMMARY--MEDCIARE SHARED SAVINGS/ACCOUNTABLE CARE ORGANIZATION (ACO) PROGRAM 1 DETAILED SUMMARY--MEDCIARE SHARED SAVINGS/ACCOUNTABLE CARE ORGANIZATION (ACO) PROGRAM Definition of ACO General Concept An ACO refers to a group of physician and other healthcare providers and suppliers

More information

6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series

6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series 6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series The healthcare industry is undergoing significant change in the face of the

More information

Accountable Care: Clinical Integration is the Foundation

Accountable Care: Clinical Integration is the Foundation Solutions for Value-Based Care Accountable Care: Clinical Integration is the Foundation Clinical Integration Care CoordinatioN ACO Information Technology Financial Management The Accountable Care Organization

More information

Changes for Calendar Year 2015 Physician Quality Programs and Other Programs in the Medicare Physician Fee Schedule

Changes for Calendar Year 2015 Physician Quality Programs and Other Programs in the Medicare Physician Fee Schedule DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE October 31, 2014 Contact: CMS

More information

Financial and Population Analytics for Accountable Care Organizations SEPTEMBER 20, 2012

Financial and Population Analytics for Accountable Care Organizations SEPTEMBER 20, 2012 Financial and Population Analytics for Accountable Care Organizations Valence Biographies Lori Fox Ward is Senior Vice President of Clinical Integration for Valence Health where her primary role involves

More information

Banner Health Network Pioneer ACO - Physician Toolkit

Banner Health Network Pioneer ACO - Physician Toolkit & The Banner Health Network, an AIP and Banner Health partnership, present the Banner Health Network Pioneer ACO - Physician Toolkit This BHN Pioneer ACO Physician Toolkit has been developed to provide

More information

ISSUE BRIEF Accountable Care Organizations March 2009

ISSUE BRIEF Accountable Care Organizations March 2009 ISSUE BRIEF Accountable Care Organizations March 2009 Reforming Provider Payment Moving Toward Accountability for Quality and Value Introduction The ongoing debate over health care reform in the United

More information

Accountable care payment

Accountable care payment Accountable care payment Jack Ashby For the Honolulu Subarea Health Planning Council of the Hawaii SHPDA March 1, 2011 Agenda for the presentation Describe major forms of accountable care payment Identify

More information

Payor Perspectives on Provider Realignment and ACOs

Payor Perspectives on Provider Realignment and ACOs Payor Perspectives on Provider Realignment and ACOs Joel L. Michaels March 15, 2011 Overview Issues to be addressed Medicare Shared Savings Program overview ACO organization options Health care reform

More information

Accountable Care Organizations: An old idea with new potential. Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010

Accountable Care Organizations: An old idea with new potential. Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Accountable Care Organizations: An old idea with new potential Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Impetus for ACO Formation Increased health care cost From

More information

Payment Reform in Massachusetts: Impact and Opportunities for the Health Care Workforce

Payment Reform in Massachusetts: Impact and Opportunities for the Health Care Workforce Payment Reform in Massachusetts: Impact and Opportunities for the Health Care Workforce Jessica Larochelle July 9, 2014 Overview Forces driving payment and delivery system reform Overview of payment and

More information

A Foundation for Health Care Reform Legislation

A Foundation for Health Care Reform Legislation A Foundation for Health Care Reform Legislation Mayo Clinic s Point of View Mayo Clinic believes that U.S. health care urgently needs reform to ensure access to quality, affordable patient care. Each major

More information

Medicare ACO Road Map

Medicare ACO Road Map PYALeadership Briefing Medicare ACO Road Map January, 2013 Medicare ACO Road Map The Centers for Medicare & Medicaid Services ( CMS ) has announced 106 new accountable care organizations ( ACOs ) have

More information

Hospital and Independent Physician Alignment: Structural Options, Business and Compliance Considerations

Hospital and Independent Physician Alignment: Structural Options, Business and Compliance Considerations Hospital and Independent Physician Alignment: Structural Options, Business and Compliance Considerations By Bruce A. Johnson and Janice Anderson I. Introduction Numerous policy initiatives are now being

More information

Cornerstone Health Care s ACO Playbook. Grace E. Terrell, MD January 17, 2012

Cornerstone Health Care s ACO Playbook. Grace E. Terrell, MD January 17, 2012 Cornerstone Health Care s ACO Playbook Grace E. Terrell, MD January 17, 2012 Mission: To be your medical home Vision: To be the model for physician-led health care in America Values: As a physician owned

More information

Newsroom. The quality measures are organized into four domains:

Newsroom. The quality measures are organized into four domains: Newsroom People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other care providers to coordinate their care under a final

More information

2013 MEDICARE FEE-FOR-SERVICE QUALITY AND RESOURCE USE REPORT

2013 MEDICARE FEE-FOR-SERVICE QUALITY AND RESOURCE USE REPORT 2013 MEDICARE FEE-FOR-SERVICE QUALITY AND RESOURCE USE REPORT Sample Medical Practice Last Four Digits of Your Taxpayer Identification Number (TIN): 1530 ABOUT THIS REPORT FROM MEDICARE WHAT This Quality

More information

ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT

ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT Accountable Care Analytics: Developing a Trusted 360 Degree View of the Patient Introduction Recent federal regulations have

More information

Practice Advisory on Collaborative Drug Therapy Management

Practice Advisory on Collaborative Drug Therapy Management I. Introduction Practice Advisory on Collaborative Drug Therapy Management Collaborative drug therapy management (CDTM) is a formal partnership between a pharmacist and physician or group of pharmacists

More information

Brief Course. Neil Kirschner, Ph.D. Director, Regulatory and Insurer Affairs

Brief Course. Neil Kirschner, Ph.D. Director, Regulatory and Insurer Affairs Accountable Care Organization (ACO) 101 Brief Course Neil Kirschner, Ph.D. Director, Regulatory and Insurer Affairs What is an ACO? ACO refers to a legal entity composed of a group of providers that assume

More information

Enterprise Analytics Strategic Planning

Enterprise Analytics Strategic Planning Enterprise Analytics Strategic Planning June 5, 2013 1 "The first question a data driven organization needs to ask itself is not "what do we think?" but rather "what do we know? Big Data: The Management

More information