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Cover image of Pathways to a Successful Accountable Care Organization
Cover image of Pathways to a Successful Accountable Care Organization
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Pathways to a Successful Accountable Care Organization

edited by Peter A. Gross, MD

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A valuable guide to starting and running a successful accountable care organization.

Health care in America is undergoing great change. Soon, accountable care organizations—health care organizations that tie provider reimbursements to quality metrics and reductions in the cost of care—will be ubiquitous. But how do you set up an ACO? How does an ACO function? And what are the keys to creating a profitable ACO?

Pathways to a Successful Accountable Care Organization will help guide you through the complicated process of establishing and running an ACO. Peter A. Gross, MD, who has firsthand...

A valuable guide to starting and running a successful accountable care organization.

Health care in America is undergoing great change. Soon, accountable care organizations—health care organizations that tie provider reimbursements to quality metrics and reductions in the cost of care—will be ubiquitous. But how do you set up an ACO? How does an ACO function? And what are the keys to creating a profitable ACO?

Pathways to a Successful Accountable Care Organization will help guide you through the complicated process of establishing and running an ACO. Peter A. Gross, MD, who has firsthand experience as the chairman of a successful ACO, breaks down how he did it and describes the pitfalls he discovered along the way. In-depth essays by a group of expert authors touch on

• the essential ingredients of a successful ACO
• monitoring and submitting Group Practice Reporting Option quality measures
• mastering your patients' responses to the Consumer Assessment of Health Plans Survey
• how bundled payments and CPC+ can meld with your ACO
• how MACRA and MIPS affect your ACO
• the role of an ACO/CIN
• the complexities of post-acute care
• data analytics
• engaging and integrating physician practices


Dr. Gross and his colleagues are in a perfect position to guide other health care leaders through the ACO process while also providing excellent case studies for policy professionals who are interested in how their work influences health care delivery. Readers will come away with the necessary knowledge to thrive and be rewarded with cost savings.

Contributors: Joshua Bennett, Allison Brennan, Glen Champlin, Kris Corwin, Guy D'Andrea, Joseph F. Damore, Mitchel Easton, Andy Edeburn, Seth Edwards, Jennifer Gasperini, Kris Gates, Shawn Griffin, Peter A. Gross, Brent Hardaway, Mark Hiller, Beth Ireton, Thomas Kloos, Jeremy Mathis, Miriam McKisic, Morey Menacker, Denise Patriaco, Elyse Pegler, John Pitsikoulis, Michael Schweitzer, Bryan F. Smith

Reviews

Reviews

As medicine moves from volume to value, from fee-for-service therapy to improved efforts to prevent illness and accidents along with cost-effective care, this book can light the way for improved health and economic success. Pathways to a Successful Accountable Care Organization will be of special value to hospital and physician administrators.

About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
344
ISBN
9781421438252
Illustration Description
6 halftones, 32 line drawings
Table of Contents

Contributors
Preface
Acknowledgments
Chapter 1. Essential Ingredients of a Successful Accountable Care Organization
Peter A. Gross
Chapter 2. Patient-Centered Medical Homes: A Key Building Block for

Contributors
Preface
Acknowledgments
Chapter 1. Essential Ingredients of a Successful Accountable Care Organization
Peter A. Gross
Chapter 2. Patient-Centered Medical Homes: A Key Building Block for Accountable Care Organizations
Joshua Bennett
Chapter 3. Care Coordination: Initial Plans and Evolution
Denise Patriaco
Chapter 4. Quality Measurement in Accountable Care Organizations
Guy D'Andrea and Kris Corwin
Chapter 5. Monitoring and Submitting Quality Measures for the Group Practice Reporting Option: CMS Web Interface
Kris Gates
Chapter 6. Live Experience of a Quality Measure Validation Audit
Mitchel Easton
Chapter 7. Ready, Risk, Reward: Building Successful Two-Sided Risk Models
Brent Hardaway, Elyse Pegler, and Bryan Smith
Chapter 8. Post-Acute Care: A Key Consideration for an Accountable Care Organization
Andy Edeburn
Chapter 9. Data Analytics: Making a Choice
Shawn Griffin
Chapter 10. Impact of Coding and Documentation on Risk Scores
Glen Champlin and John Pitsikoulis
Chapter 11. Legal and Compliance Considerations
Seth Edwards
Chapter 12. Employee Health Management and the Role of an Accountable Care Organization
Jeremy Mathis
Chapter 13. The Role of Primary Care in the Future of Health Care
Morey Menacker
Chapter 14. Practice Transformation: Engaging and Integrating Physician Practices
Thomas Kloos
Chapter 15. Population Health Management Consulting
Joseph F. Damore
Chapter 16. The Comprehensive Primary Care Plus Initiative
Seth Edwards
Chapter 17. Keys to Success in Bundled Payments
Mark Hiller, Beth Ireton, Miriam McKisic, and Mike Schweitzer
Afterword
Index

Author Bio
Featured Contributor

Peter A. Gross, MD

Peter A. Gross, MD is the chairman of the Hackensack Alliance Accountable Care Organization, which (in 2019) succeeded in achieving cost savings six years in a row totaling $194 million, with net distributed savings of $86 million. He is also a professor of medicine at the Hackensack Meridian School of Medicine at Seton Hall.