On July 1, the Centers for Medicare and Medicaid (CMS) announced that the Accountable Care Organization (ACO) medicare market more than doubled in size with 89 newly named participants. The 89 joined the 27 ACOs already in the shared-savings program which offers medical groups, hospitals and some health centers financial incentives for cost control and quality improvements.
ACOs are created by a group of healthcare providers who believe that by working together they’ll be able to provide the right care at the right time. In fact, the CMS is holding the organizations to five categories to measure their performance:
- patient/caregiver experience
- patient safety
- preventative health
- care coordination
- at-risk population/frail elderly health
What does this mean for you?
Last year, the Synchrony team was able to glean some insights about how this will affect the healthcare industry during a meeting with Harry Reynolds, director of health transformation at IBM. As the industry moves towards ACOs or Medical Homes, customer service will be of utmost importance. Not only will patients be able to choose to visit doctors outside an ACO if they are unhappy with their service – which should cause every member of an ACO to do their best to deliver an excellent patient/caregiver experience so the entire ACO system does not lose a customer – but the ACOs are being held accountable for the customer experience in order to receive funding.
How can this be done?
Because of this, ACOs will need to establish best practices and standardize treatments. They could also choose to improve the patient experience by driving a guided interaction across caregivers and across organizations.
Other options that could also help lower the cost of care include finding a way to manage the availability of provider resources, enabling a better self-service experience and shortening the revenue cycle by eliminating data entry and coordination of benefits errors.