Download or read book Accountable Care Organizations written by Marc Bard and published by ACHE Management. This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Is the ACO strategy right for your organization? Accountable Care Organizations will help you understand the ACO framework and assess your readiness to embark on an ACO strategy. This book provides the structural blueprints, management skills, and cultural tools necessary to implement a successful ACO. Practical advice is bolstered with real world examples of leading healthcare providers that are pioneers in the rapidly changing world of accountable care. This guidebook is designed to facilitate critical conversations and decisions at all stages of the ACO development journey. Explore processes and structures and learn how to implement pilots to shape your own ACO delivery model. Each chapter includes takeaway points and tailored action steps for: (1) organizations interested in exploring the ACO concept, (2) organizations taking the first steps towards an ACO model, and (3) organizations already moving full speed ahead. This book will help you answer these questions and more: What does it take to become an ACO? What steps and actions should your organization take to implement an ACO strategy? How can organizational culture support your move to accountable care? How can you build a business plan to support an ACO strategy? What information technology is needed to implement an ACO strategy? How can an merging ACO best negotiate with third-party payers?
Download or read book The ACO Handbook written by Peter A. Pavarini and published by . This book was released on 2015 with total page 565 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Health Care Handbook written by Elisabeth T. Askin and published by Lippincott Williams & Wilkins. This book was released on 2022-11-21 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: Described in the New York Times as “an astonishingly clear ‘user’s manual’ that explains our health care system and the policies that will change it,” The Health Care Handbook, by Drs. Elisabeth Askin and Nathan Moore, offers a practical, neutral, and readable overview of the U.S. health care system in a compact, convenient format. The fully revised third edition provides concise coverage on health care delivery, insurance and economics, policy, and reform—all critical components of the system in which health care professionals work. Written in a conversational and accessible tone, this popular, highly regarded handbook serves as a “one stop shop” for essential facts, systems, concepts, and analysis of the U.S. health care system, providing the tools you need to confidently evaluate current health care policy and controversies.
Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Download or read book A Guide to Consulting Services for Emerging Healthcare Organizations written by Robert James Cimasi and published by . This book was released on 1999-06-16 with total page 538 pages. Available in PDF, EPUB and Kindle. Book excerpt: Is your consulting practice ready to serve the needs of the new healthcare organizations? As Emerging Healthcare Organizations (EHOs) rapidly replace traditional ways of delivering healthcare, accountants and other consultants to healthcare providers will face greater demands—and potentially reap greater rewards—than ever before. In A Guide to Consulting Services for Emerging Healthcare Organizations, healthcare consulting expert Robert James Cimasi offers a comprehensive and authoritative guide to the full spectrum of these EHOs and the opportunities they offer consultants and their clients who need to understand them and their unique requirements.
Download or read book Integrating Social Care into the Delivery of Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-30 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Download or read book The Medicare Handbook written by and published by . This book was released on 1988 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2019-02-14 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.
Download or read book Performance Measurement written by Institute of Medicine and published by National Academies Press. This book was released on 2006-07-09 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: Performance Measurement is the first in a new series of an ongoing effort by the Institute of Medicine (IOM) to improve health care quality. Performance Measurement offers a comprehensive review of available measures and introduces a new framework to examine these measures against the six aims of the health care system: health care should be safe, effective, patient-centered, timely, efficient, and equitable. This new book also addresses the gaps in performance measurement and introduces the need for measures that are longitudinal, comprehensive, population-based, and patient-centered. This book is directed toward all concerned with improving the quality and performance of the nation's health care system in its multiple dimensions and in both the public and private sectors.
Download or read book Mistreated written by Robert Pearl and published by PublicAffairs. This book was released on 2017-05-02 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: The biggest problem in American health care is us Do you know how to tell good health care from bad health care? Guess again. As patients, we wrongly assume the "best" care is dependent mainly on the newest medications, the most complex treatments, and the smartest doctors. But Americans look for health-care solutions in the wrong places. For example, hundreds of thousands of lives could be saved each year if doctors reduced common errors and maximized preventive medicine. For Dr. Robert Pearl, these kinds of mistakes are a matter of professional importance, but also personal significance: he lost his own father due in part to poor communication and treatment planning by doctors. And consumers make costly mistakes too: we demand modern information technology from our banks, airlines, and retailers, but we passively accept last century's technology in our health care. Solving the challenges of health care starts with understanding these problems. Mistreated explains why subconscious misperceptions are so common in medicine, and shows how modifying the structure, technology, financing, and leadership of American health care could radically improve quality outcomes. This important book proves we can overcome our fears and faulty assumptions, and provides a roadmap for a better, healthier future.
Download or read book Creating the Accountable Organization written by Mark Samuel and published by . This book was released on 2006-01-01 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical guide to bringing accountability into the workplace and into the daily life of managers and staff. This book provides a working guide, through specific examples, of what accountability is; how to instill it within your company; and how to measure and quantify its effectiveness. Accountability has become significantly more important as corporate scandals have rocked the country. Here is the one book to have to bring positive change to your workplace and daily life.
Download or read book The U S Healthcare Ecosystem Payers Providers Producers written by Lawton Robert Burns and published by McGraw Hill Professional. This book was released on 2021-03-16 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: An Essential Guide to the Processes and Operational Complexities of the U.S. Healthcare System The U.S. Healthcare Ecosystem serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem will inspire you to think more critically about the business of healthcare and make informed assessments. Features: Includes often neglected topics impacting healthcare delivery such as employer-based health insurance, pharmacy benefits, healthcare consolidation, and biotechnology Highly readable and single-authored by a Wharton Professor who has taught health care delivery and management for over 20 years Filled to the brim with helpful diagrams, charts and tables - nearly 350 figures complement the text Every chapter ends with a helpful Summary and Questions to Ponder
Download or read book Accountable Care Organizations written by Robert James Cimasi and published by CRC Press. This book was released on 2013-06-05 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: An accountable care organization (ACO) is a healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned group of patients. Accountable Care Organizations: Value Metrics and Capital Formation explores the historical background and evolution of the ACO model as the basis for the development of the value metrics and capital formation analyses that are foundational to assessing the current efficacy and capacity for change. The book examines the four pillars of value in the healthcare industry: regulatory, reimbursement, competition, and technology in addressing the value metrics of ACOs, including requirements for capital formation, financial feasibility, and economic returns. It focuses the discussion of non-monetary value on a review of aspects of population health within the context of such objectives as improved quality outcomes and access to care. Explains why ACOs might be the cost-containment and quality improvement answer the industry has been looking for Describes the circumstances and capital structures where ACOs represent a sound investment Includes a foreword by Peter A. Pavarini, Esq. The book examines the positive externalities of the ACO model, including results for third parties outside the basic construct of the ACO contracts shared savings payments. It also discusses the potential role and opportunities for consultants in assisting their provider clients in the consideration, development, implementation, and operation of an ACO.
Download or read book Provider based Entities written by Gina M. Reese and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book serves as a comprehensive guide to provider-based clinics, from qualifying under CMS, to unique billing and coding rules, and the business decisions behind owning or acquiring these clinics. It will help readers sort through the complex regulations relevant to this unique provider type, and provide insight into recent changes, such as the introduction of Modifier -PO. CMS is looking to implement the Section 603 provisions of the Bipartisan Budget Act of 2015 regarding off-campus, provider-based departments (PBD) by January 1, 2017, according to the 2017 OPPS proposed rule. The agency is proposing to pay the nonfacility or office Medicare Physician Fee Schedule (MPFS) amount to the performing/supervising physician and preclude hospitals from billing on a UB-04 form or receiving OPPS payment for services performed at these locations for 2017, but plans to explore other options for 2018 and beyond. Physicians would be paid at the higher nonfacility rate of the MPFS, but only hospitals that have employed or contracted physicians that reassign their billing to the hospital would get paid under the MPFS for these services. Hospitals would be able to bill claims on CMS-1500 forms for physicians who have already reassigned their billing to the hospital, as in the case of employed physicians. Otherwise, hospitals would have the option of enrolling the location as the type of provider or supplier it wishes to bill to meet the requirements of that payment system (e.g., ambulatory surgery center or group practice).
Download or read book Healthcare Operations Management written by Daniel B. McLaughlin and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Credentialing Privileging and Medical Staff Governance written by Sheri Patterson and published by . This book was released on 2018 with total page 269 pages. Available in PDF, EPUB and Kindle. Book excerpt:
