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Accountable Care

Healthcare’s Next Revolution: Finding Success in the Medicare Shared Savings Program (Executive Report)

A series of revolutions has driven the development of the U.S. healthcare system, enabling dramatic improvements in all aspects of healthcare quality and outcomes over the past century. Although healthcare organizations have focused on moving towards value-based care for decades, the data shows that the shift is indeed taking place and fee-for-service models are declining.

New changes to the Medicare Shared Savings Program (MSSP) will help drive this change as revisions to MSSP require ACOs to take on more financial risk earlier. This article covers the following topics:

  1. Important moments in history that led to today’s current challenges.
  2. Why financial imperatives drive cultural change in our economic model.
  3. Ways MSSP can help healthcare organizations achieve financial success.
  4. How to utilize data to develop better healthcare delivery systems.

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Accountable Care Transformation Framework (Executive Report)

To succeed in a value-based care environment, accountable care organizations (ACO) require a solid foundation built on five competencies of population health management: infrastructure, population evaluation, provider network, quality and safety, and waste reduction. Once the foundation is built, the healthcare organization can package this “asset” to enter into truly beneficial agreements as outlined in this groundbreaking Accountable Care Transformation Framework.

Understanding the Future of Shared Accountability (white paper)

About 40% of U.S. healthcare providers are participating in some type of shared accountability arrangement.. That means that the majority is on the sideline in a “wait and see” mode. Yet this trend will move forward, albeit in fits and starts, as purchasers and providers understand that they have oversimplified and undervalued what the other participants in the equation contribute.  As the industry moves through three phases of vertical integration, fair-sighted accountable care initiatives will need to focus on at least three critical elements in designing their system for success in the steady state, including: 1) constructing the vertically integrated healthcare delivery system, 2) stratifying and allocating the risk, and 3) managing the financial risk.