ACO Reporting- A Patient-Centered Approach

An ACO (Accountable Care Organization) works for the better care of patients. Consider it as a group that combines hospitals, doctors, and other healthcare specialists for the sake of providing healthcare and is a team in care decisions. They aim to improve your health by ensuring that you get custom care according to your needs while cutting costs.

In addition, clear and transparent reporting emphasizes trust among patients, providers, and stakeholders for high-quality outcomes.

For Which Factors ACO Is Responsible For?

Quality Benchmarks

ACOs report on multiple quality measures for the effectiveness of care quality. For instance, patient and caregiver experience, care coordination, and patient safety.

Patient Experience

Patient satisfaction level and their experiences are necessary components. So, under the umbrella of ACO reporting services, surveys are conducted with the help of a tool named CAHPS (Consumer Assessment of Healthcare Providers and Systems) to collect data regarding patient experiences which also point out the areas where improvement is required for physicians.

Performance Improvement

ACOs do not restrict themselves to certain defined goals instead, they take a holistic approach focusing on overall patient outcomes, cost efficiency, and quality of care. This becomes a specific reason for comprehensible improvements in patient care.

Enhancing Quality

By examining doctors’ performance, ACOs identify strengths and weaknesses in the service of healthcare delivery. It does not restrict itself to temporary or timely reporting only but fosters continuous quality improvement.

Regulatory Compliance

ACOS must adhere to rules set forth by government bodies such as CMS (Centers for Medicare and Medicaid Services). Complying with all these regulations helps in avoiding penalties.

Role of MSSP in ACO

ACOs participation in MSSP (Medicare Shared Savings Program) is mandated to report measures for doctors regarding their services through QPP (Quality Payment Program). Moreover, it incorporates CMS WEB Interface, a reporting tool for managing the data and easily tracking performance.

Requirements and Criteria for being an ACO Participant

According to federal laws, 4 major points are required to be part of ACO.

• ACO Expertise, for instance, health care providers, physician assistants, nurse practitioners, and clinical nurse specialists in group practices.
• Network incorporating individual practices of ACO Professionals.
• Joint venture and collaborative partnerships incorporating hospitals and healthcare professionals.
• Another way for entities to be part of an ACO is through hospitals that employ ACO professionals.

2024 Updates Regarding ACO

CMS has announced that about 19 new ACOs will participate in the Medicare shared savings program in 2024 which is benefitting ACOs to obtain over $20 million in AIPs (Advanced investment payments) to provide care for marginalized populations.

3 Groundbreaking ACO Initiatives in 2024

The shared savings program, a permanent ACO program, and the ACO REACH Model have been introduced to boost the care for those individuals who are in rural areas.  These initiatives enhance the quality of care for individuals with traditional Medicare.

2024 Growth in ACO

There is a 3% rise from 2023 and about 13.7 million people in 2024 along with Traditional Medicare associated with an ACO.

Streamlining Revenue Cycle Management for ACOs By Minimizing Errors

The revenue cycle process revolves around managing the patient billing system efficiently and maximizing revenue. Therefore, P3Care assists ACOs in the said operations minimizing the hefty burden of administrative tasks. So that they can focus on the quality of care by constant monitoring.

3 Obligatory Criteria for Advanced APM

• Participants have to utilize electronic health record technology for better outcomes.
• Payments of covered professional services rely on quality measures that are similar to the quality performance category of MIPS.

Conclusion

P3 Care encourages ACOs to streamline their operations which ultimately maximizes their reimbursement. Alongside, this holistic approach ensures that patient requirements and preferences remain paramount for providing quality care.