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Jumping into the accountable care organisation model

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The US healthcare system is continuing to face many challenges, including rising healthcare costs, and issues related to quality and safety – driving healthcare reform. To address these challenges healthcare providers are looking to provide higher levels of care while controlling the cost of care. The approach that is rapidly being adopted is to establish Accountable Care Organizations (ACOs) or Clinically Integrated Networks (CINs). The number of ACOs across the US has grown significantly over the past several years. To effectively support an ACO or CIN model the organisation needs to address key focus areas that are different from traditional hospital or community practice group functions or capabilities. Establishing an ACO/CIN requires very different operations, financial, and technologies from traditional fee-for-service healthcare payment models. Many ACOs are challenged with becoming financially self-sufficient due to the significant upfront investments in provider performance programmes, technologies and infrastructure which may not be the best initial investments to drive the return of investment of a population health management programme. New ACOs/CINs and financially struggling ACOs/CINs can benefit by understanding the key areas to focus as they expand services. Knowledge gained from the paper provides ACO executives areas to focus to develop successful ACO operations.
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Keywords: Accountable Care Organization (ACO); Clinical Integration Network (CIN); PHM strategy; Population Health Management (PHM); healthcare technologies for value-based contracts

Document Type: Research Article

Publication date: March 1, 2016

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  • Management in Healthcare is the major new professional journal publishing in-depth, peer-reviewed articles and case studies on leadership, administration and management in healthcare. Content will be written by and for healthcare management professionals and researchers with no advertising or sales pitches.

    Each quarterly 100-page issue – published in print and online – will feature detailed, practical articles on key business issues which cut through the deluge of information facing healthcare management professionals to showcase the latest thought leadership in how to deliver more with less resources while at the same time improving healthcare quality, along with actionable advice and ‘lessons learned’ from fellow healthcare managers to put that strategy into practice. It will not publish advertising but rather detailed analysis of new thinking and practice at a wide range of healthcare providers worldwide for readers to benchmark their organization against, with every article being peer-reviewed by an expert Editorial Board to ensure that it focuses on the healthcare manager’s perspective, the challenges they face and how they can tackle them.

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