Six Key Areas of Health Reform
The rules are changing. Healthcare organizations need to make sure they stay in the game with new strategies for success.
- Bundled payments will provide payment for an array of services. For example, acute care episodes will be reimbursed for the services provided in the hospital as well as for the follow-up outpatient care.
- Accountable Care Organizations (ACO) bundle the services of hospitals, physicians and other providers who are delivering services during an episode of care. Within these organizations, providers work together to achieve measured quality targets and then demonstrate reductions in the overall spending growth for a defined population of patients. The goal: Reduced costs as provider collaborations are organized around the ability to achieve shared-savings bonuses.
- Patient-centered medical homes are interdisciplinary, community-centered groups that support multiple types of primary care within a hospital service area and are also aimed at reducing the overall costs of care.
Some of the implications of these new payment models include:
- Positive revenue impact for high-performing providers
- Negative financial impact for providers that cannot demonstrate operational efficiency
- The need for a technical infrastructure capable of sharing information and managing payments across multiple providers
With these challenges, providers need to reinvent for reform by deploying technology that enables high performance, supports multi-setting care models and provides the flexibility necessary to accommodate new payment paradigms.