Accountable Care Organizations (ACOs) have evolved as a revolutionary healthcare delivery approach. All-in-all, they have three main goals for healthcare: cost-cutting, care coordination, and quality enhancement. So, ACO reporting is one way of evaluating the progress of Medicare ACOs toward meeting the preset goals. CMS analyzes data collected from specified Medicare populations by these accountable care organizations. Afterward, if the ACO satisfies certain criteria, they get their share of Medicare Shared Savings or Penalties.
In this blog, we will examine the benefits of being a part of an accountable care organization. And how providers can use the power of ACO reporting to secure the future of their practice.
Accountable Care Organization (ACO) reporting is a strategic step. It provides several benefits to healthcare organizations. Some of these benefits are given as follows:
- Enhanced patient care coordination
- Data-driven decision-making
- Financial incentives and benefits
Let’s delve into the benefits of participating in ACO reporting.
When ACOs aggregate reporting data, they get valuable insights into patient health patterns, histories, and treatment outcomes. This data collection helps them analyze and find areas for improvement in their practice. ACOs may develop targeted strategies for the betterment of their performance. Thus, an ACO Medicare counts on specific measures for evaluation of their performance. These metrics may assess different aspects. For example, timely communication, care transitions, medication reconciliation, follow-up care, etc.
Another unsaid benefit of ACO data collection for reporting is the identification of high-risk patients. For this, the ACOs consider the data on hospital readmissions, emergency visits, and chronic conditions. Afterward, they practice targeted care management services for such patients.
Nonetheless, every provider who has associated their TIN with an ACO plays a role in care optimization. From the reporting data, ACOs can pinpoint elements that have worked well and those that need improvement. For example,
- ACO data may demonstrate that certain providers regularly produce outstanding patient outcomes.
- Moreover, it may identify which practices have offered the treatment at the lowest cost.
Thus, we can identify the best practices using this data. ACO reporting participants can then implement evidence-based protocols and best practices.
Consequently, they will be able to fill the gaps in care with better clinical decision-making. They may implement preventive measures and allocate resources so efficiently.
ACOs are rewarded for enhancing the standard of care. These rewards are meant to motivate ACOs. It’s crucial to keep in mind that the precise financial incentives offered to ACOs might change based on:
- The ACO program
- Government regulations
- Payer contracts
To comprehend the financial incentives available to them, ACOs should carefully check the program’s terms and conditions. Here are some typical financial rewards for ACOs in ACO reporting:
One of the primary financial incentives for ACOs is getting a share of Medicare savings. An ACO may obtain a share of the savings made if it satisfies specific quality and cost criteria. For this, we have a simple method for determining shared savings. Thus, we can find the shared savings rate by subtracting the actual costs from a benchmark set by CMS.
It encompasses both shared gains and losses. ACOs that accept two-sided risk achieve their quality and cost targets and obtain higher shared savings percentages. If they go over budget, they can also be subject to financial penalties.
Depending on how well ACOs execute against certain quality benchmarks, they may be compensated. However, the compensation completely depends on the ACO’s performance.
ACOs can participate in advanced APMs as well. Both MSSP Tracks 2 and 3 and the Next Generation ACO Model are advanced APM models. Thus, ACOs are eligible for further financial incentives by taking part in this.
To conclude, we must say that ACO reporting paves the way for a future where patient-centric care and sustainable healthcare systems thrive. The providers get many benefits as part of accountable care organizations with ACO reporting services. Not only do they practice to improve patient care, but they also attain operational efficiency. Moreover, they also achieve financial success by getting shared savings or other incentives.