For healthcare providers, the ACO model presents strengths and weaknesses, opportunities and threats.
Boston, October 11, 2011 – A new report from Aite Group analyzes guidelines for building successful accountable care organizations (ACOs) as outlined by the Center of Medicare and Medicaid Services. Based on more than 20 Aite Group conversations with industry participants at solutions vendors and financial institutions, the report provides the ACO-adoption timeline suggested by the Patient Protection and Affordability Care Act (PPACA); conducts a high-level analysis of the strengths, weaknesses, opportunities, and threats of ACOs; and discusses key opportunities for financial institutions and solutions vendors to build solutions that cater to ACOs.
ACOs, mandated by the PPACA, were created by the U.S. government as a provider-shared savings program for Medicare expenditures. The entities are designed to promote provider accountability to patients by focusing on improving the quality of care administered, increasing the effectiveness of services delivered, automating infrastructure, coordinating procedures and items covered by Medicare Part A and Medicare Part B, and increasing the efficiency of fee-for-service-based programs. While ACOs are primarily meant to improve revenue-cycle management and reduce risks at providers, adoption has been lackluster—particularly among small and midsize providers.
“Low levels of awareness in the provider community have led to providers not properly understanding the benefits of enrolling in an ACO,” says Kunal Pandya, senior analyst with Aite Group and author of this report. “The model presents strengths and weaknesses, opportunities and threats. Regardless, Aite Group recommends that providers get involved early, while participation is still optional.”
This 16-page Impact Note contains two figures. Clients of Aite Group's Health Insurance service can download the report.