Current Payment Model Ffs Payment

2285 Words Oct 19th, 2014 10 Pages
Introduction An Accountable Care Organization or ACO is a group of doctors, hospitals, and healthcare providers, who voluntarily come together and provide coordinated high quality medical care to Medicare patients.
Coordinated care is generally intended to guarantee that patients (especially the chronically ill) get the appropriate care at the right time, avoid service duplication and averting medical errors, in the process.
In PPACA or Obamacare, each ACO manages the health care needs of at least 5,000 Medicare beneficiaries for around three years.
ACOs are representative of a significant shift from a health care system focused on payment to largely rewards volume, rather than value, of services.
When an ACO succeeds, both in delivering high-quality care and spending health care dollars wisely, it shares in the savings achieved for the Medicare program.
Figure 1: Transformation in cancer care reform
Current Payment Model FFS Payment to Clinicians Drug Costs Payments for all other Cancer care Waste/ Inefficiency
ACO Payment Model FFS Payment to Clinicians Shared Saving Payment Drug Costs Payments for all other Cancer care Waste/ Inefficiency Total Cost of Cancer Care
Medicare provided ACO programs
● Medicare Shared Savings Program - a program aimed at helping a Medicare fee-for-service program provider transform into an ACO.
● Advance Payment ACO Model – an additional incentive program devised for select participants in the shared program.
● Pioneer ACO Model - a…

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