Are You Participating in an ACO Yet? Well, Why Not?

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Amy Shellhart By Amy Shellhart 
Director of Product Management, Change Healthcare
Accountable care organization and home health organization partnership

With the recent announcement of the first group of Next Generation ACOs, 447 accountable care organizations are now serving nearly 8.9 million Medicare patients in 49 states and the District of Columbia.

A total of 21 ACOS are participating in the Centers for Medicare & Medicaid Services’ (CMS) Next Generation ACO program from Arizona, California, Florida, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Pennsylvania, North Carolina, Texas and Wisconsin.

New opportunities are available for those home care organizations that are displaying innovation, working as part of a care team, and assuming some (or all) risk for the care your organization provides patients. The Department of Health and Human Services in January 2015 announced ambitious plans to shift 30% of all Medicare payments by 2016 to alternative payment models that stress care quality over service volumes. By 2018, the payment goal is 50%.

At the time, we wondered what home care organizations were doing to prepare for this monumental shift in reimbursement and assignment of risk for outcomes. And it’s a question that bears repeating: What are you doing to partner with local health systems, in-patient rehabilitation centers, nursing homes and physician offices?

For most home care organizations, federal payers like Medicare account for the lion’s share of patients. When the feds step up with so many programs all aimed at linking reimbursement to outcomes among this population, you should quickly understand that the care you are providing today may not fit with the type of care that will be required tomorrow.

Regardless of where your organization is located, every home care agency should be looking at ways to participate in these new care models. If you’re interested in participating in the Next Generation ACO model in 2017, letters of intent and applications will be made available this spring.

How is your organization participating in these new care and reimbursement models? Reply and let us know.

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