Accountable Care

New rules released Thursday include a third track for providers to take on higher risk and to share in increased savings.

Healthcare payment structures are changing, but won't necessarily hurt healthcare system's finances.

Leaders like Banner Health, Montefiore explain what it took to succeed in the first ACO model, and look towards new programs that give them shared risk incentives for care quality.

The most difficult challenges to value-based reimbursement reside within the cultural and operational sides of the business, and not technology, experts say.

New Hampshire ACO's goal is to have capitation make up 70 percent of reimbursements, dropping fee-for-service from its current 50 percent to 30 percent.

The nature of the risk under the CMS Pioneer ACO and Shared Savings programs is hard for providers to manage. But the Next Generation ACO program has changed the level of risk, offering providers a higher share of savings and new ways to limit unpredictable losses.

Before committing to partnerships within a parochial healthcare network, all the players must know the stakes, the options available and most importantly, the methodology for proceeding with a business model that is foreign to most provider organizations.

Patient engagement can ensure the delivery of patient- and family-centered care while bolstering the ability of accountable care organizations to meet quality and savings goals.

With the Oncology Care Model, participating practices will have their chemotherapy treatments tracked and measured for the necessity and outcome of the treatment, as well as the coordination of care that leads up to the cancer treatment.

Perhaps the biggest value-based challenge on the finance side is the lack of a single set of metrics by which to gauge quality.