Link: Modern Healthcare

The Affordable Care Act (ACA) authorized the Secretary of the Department of Health and Human Services (HHS) to enter into agreements with Accountable Care Organizations (ACOs) on a shared savings basis with the goals of improved health outcomes and efficiency. Medicare Shared Savings Program (MSSP) ACOs are measured on the quality of the patient experience, preventive care and disease management and some of the leading causes of death among U.S. elderly.

In September 2014, Modern Healthcare reported that CMS released results of each ACOs’ financial performance. Of the approximately 200 ACOs, 53 reduced the cost of patient care enough to share $300 million in bonuses. These results are a significant development in Medicare cost reduction. A link to the PDF is here.

In order to monitor quality measures and metrics to achieve these goals, investment in infrastructure and redesigned care processes may have been used to monitor care provided to Medicare beneficiaries. Infrastructure might include a data warehouse that syncs data from EMRs to provide monitoring capabilities for performance standards and metrics. A data warehouse model might look like the picture below, where the ACO gathers data from a variety of sources to monitor and benchmark performance.



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