The Healthcare Intelligence Network
ACOs, Bundled Payment Pilots Encouraged PPACA
Press Release
Contact: Melanie Matthews
888-446-3530 phone
mmatthews@hin.com

Manasquan NJ USA -- April 20, 2010: Top on the list of healthcare cost containment strategies that the Patient Protection and Affordability Act will test are accountable care organizations (ACOs) and bundled payments, which seek to improve how we pay for healthcare to reward quality and coordination of care. Guided by the new Center for Medicare and Medicaid Innovation, pilot programs that successfully control Medicare costs through these episode-based payment methods will be given CMS approval to expand, instead of waiting for Congressional approval as in the past.

Medical Home Reimbursement ABCs: Funding Care Delivery through ACOs, Bundled Payments and Concrete Contracts profiles three healthcare organizations that are redefining healthcare reimbursement with their pilots of these payment models and contracting strategies.

To order your copy today, please contact HIN at 888-446-3530 or visit:
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Please reference this customer code when registering: MAB0420H

  • ACOs: When Dean Health System reengineered its practice as an ACO — a network of primary care physicians, one or more hospitals and subspecialists that provide patient-centered care — it noticed tremendous improvements in patient satisfaction and access, HEDIS and quality scores and membership numbers. The health system is now third in Wisconsin, the state ranked first for healthcare by the NCQA. Dean Health System President and CEO Dr. Craig Samitt, M.B.A., describes the recruiting, incentives and performance management strategies built into the ACO model, also known as a multispecialty group, a medical neighborhood, an integrated delivery network (IDN) or an integrated delivery system (IDS).

  • Bundled Payments: Baptist Health System experienced a "Hallmark moment" when it distributed gainshare checks to providers participating in the CMS Acute Care Episode (ACE) pilot. Michael Zucker, chief development officer for Baptist Health System, describes the motivation, preparation, experience and lessons learned thus far from Baptist's participation in the CMS demo. He provides a frank look at the challenges of structuring payments, adjusting for severity, engaging physicians and vendors, coordinating and negotiating services and preparing for transition to real-life application.

  • Contracts: As a member of the contracting team for the Dartmouth-Hitchcock Medical Center (DHMC) medical home program and a provider herself, senior medical director Barbara Walters, M.D., has earned her negotiating stripes. Experienced in negotiations with public and private payors, Dr. Walters has helped to shape financial foundations for DHMC's participation in CMS's Group Physician Practice demo for Medicare beneficiaries; a partnership with Cigna to create a medical home pilot whose reimbursement structure starts with quality, not cost; and the separate New Hampshire Citizens Health Initiative, a multi-site multi-stakeholder medical home pilot. Dr. Walters brings the industry up to speed on DHMC's negotiating activities over the last year, describing how to represent providers' interests through effective negotiations and contracts with payors for the medical home model of care.

To order your copy today, please contact HIN at 888-446-3530 or visit:
http://store.hin.com/product.asp?itemid=3952
Please reference this customer code when registering: MAB0420H

This 50-page special report provides a primer on emerging reimbursement models that are getting providers' attention while delivering cost savings. Healthcare organizations mired in the alphabet soup of healthcare reimbursement models can learn from these early pioneers of healthcare payment models.


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Medical Home Reimbursement ABCs: Funding Care Delivery through
ACOs, Bundled Payments and Concrete Contracts

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