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OVERVIEW
Implementation of accountable care organizations (ACOs) has continued to advance rapidly in the past year. The National Accountable Care Organization Summit (www.ACOSummit.com), will provide an unprecedented opportunity to discuss remaining barriers to widespread ACO implementation and strategies to overcome them. The Summit brings together leading policymakers, experts, and ACO implementers to provide unique and in-depth insights on ACO implementation and ongoing health care reform. The Summit will go over a variety of topics including strategies and technology for innovative payment models, performance measurements, delivery system reform and clinical transformation, managing vulnerable populations, and engaging patients in medical care.
WHAT IS AN ACO?
ACOs are groups of physicians, hospitals, and other providers that receive financial rewards for achieving patient-focused quality targets and demonstrating reductions in overall spending growth for their defined patient population. ACOs can be organized in a number of ways, ranging from fully integrated delivery systems to networked models within which physicians in small office practices can work together to improve quality, coordinate care, and reduce costs. ACOs can also feature different payment incentives, ranging from “one-sided” shared savings within a fee-for-service environment to a range of capitation arrangements with quality bonuses. In addition, ACOs are compatible with a range of other payment reforms, such as medical homes and bundled payments; they can help assure that these reforms lead to sustainable quality improvements and cost reductions. In sum, ACOs provide an ideal mechanism to transition from paying for volume and intensity to paying for value.
HOW IS ACO IMPLEMENTATION PROCEEDING ACROSS THE COUNTRY?
In October 2011, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Medicare Shared Savings Program. Since the ruling, CMS has recruited 220 organizations from across the nation to participate in a program that aims to promote accountability for the care of Medicare FFS beneficiaries, coordinate care for all services provided under Medicare FFS, and encourages investment in infrastructure and redesign care processes. CMS has also proposed a number of pilot programs under the Innovation Center that will encourage collaboration among providers in more focused areas, including the Advance ACO Payment Model that will help smaller ACOs with less access to capital participate in the Shared Savings Program.
Beyond Medicare ACO initiatives, interest and participation in accountable care reforms has been growing both in states and in the private sector. At least 27 states have introduced bills referring to accountable care and 12 states have already passed legislation intended to support the transition toward ACO-like models for either their Medicaid programs or state employees. In the private sector, all of the major private health plans have begun implementing payment reforms similar to the ACO model; like ACOs, these payment reforms include accountability for the full continuum of patients' care, payment contingent upon improving the quality and coordination of care, and responsibility for cost management within a target budget. In tandem with the Medicare Shared Savings Program, the Pioneer ACO Model, and other innovative programs in Medicare, these private sector efforts will be instrumental in moving ACO implementation forward as health care reform progresses.
LEARNING OBJECTIVES
At the end of this meeting, participants will be able to:
- Identify strategies that will lead to quality-based payments and examples of standards of benchmarks for quality performance, quality-of-care outcomes and efficiency.
- Identify programs and reimbursement policies that encourage provider/payor collaboration and the delivery.
- Identify various types of technologies that are being used for payment reform and population health management.
- Identify strategies and approaches when developing a care delivery team.
- Identify strategies to tackle the healthcare workforce deficit including strategies to incentivize programs for primary care physicians.
- Identify areas of opportunity for specialists in an accountable care organization.
- Identify various performance measurement tools that can help ACOs identify high-risk patients and intervene to achieve better care at a lower cost.
- Identify strategies to improve health care access for vulnerable populations including disadvantaged racial minorities, individuals of low socioeconomic status, and patients with complex medical issues.
- Identify strategies to integrate care for dual eligibles in an Accountable Care Organization.
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WHO SHOULD ATTEND
- Executives and Board Members of ACOs, Health Plans, Health Systems, Hospitals and Physician Organizations
- Medical Directors
- Physicians
- Nurses, Nurse Practitioners and Other Allied Health Professionals
- Pharmacists and Pharmacy Benefit Managers
- Representatives of Purchasers, including Private Employers and Public Purchasers
- Consumer Organization Representatives
- Federal and State Government Officials
- Health Care Regulators and Policy Makers
- Health Benefits Consultants
- Health Services Researchers and Academics
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- Health Care Attorneys and In-house Counsel
- Chief Financial Officers
- Chief Innovation Officers
- Directors of Accountable Care
- Directors of Quality Management and Improvement
- Directors of Government Programs
- Directors of Medicare Programs
- Directors of Medicaid Programs
- Directors of Network Contracting
- Directors of Provider Relations
- Directors of Finance and Reimbursement
- Pharmaceutical Executives
- Pharmaceutical Consultants
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