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AHLA The ACO Handbook: A Guide to Accountable Care Organizations (AHLA Members)

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2nd Edition
ISBN: 9781632820679
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ISBN: 9781632820693
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ISBN: 9781632820693
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It is the importance of accountable care organizations (ACOs), as much as the uncertainty about their future, that makes the Second Edition of The ACO Handbook: A Guide to Accountable Care Organizations necessary for those grappling with the changes brought about by healthcare reform. The contributors to this handbook are among the best professionals in America today who are seriously considering what it will take to succeed under the new healthcare environment. Their astute observations about the legal issues, both novel and familiar, likely to be encountered by those contemplating ACO development will be useful to the reader no matter what role these organizations ultimately play in the reformed U.S. healthcare system.

Since the passage of the Affordable Care Act, many health care opinion leaders have predicted that the ACO may be one of the most significant transformative aspects of health care reform. The ACA directed the Centers for Medicare & Medicaid Services to experiment with ways to employ high-performance provider organizations to deliver comprehensive care to a specific group of patients over an event, an episode, or a lifetime, while assuming responsibility for the clinical and financial outcomes of that care.

This new health care delivery method will require a level of cooperation and joint decision making that has often been lacking in traditional health care organizations. AHLA is pleased to bring you this greatly expanded and comprehensive second edition of The ACO Handbook: A Guide to Accountable Care Organizations.

The book analyzes various components of an optimized delivery system, and examines issues ranging from the financial aspects of ACOs to the unique nature of academic medical center, pediatric, and commercial ACOs.



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Table of Contents

Table of Contents

1   The Growth and Importance of Accountable Care Organizations

2   Hospital/Physician Integration Models Before the ACA

3   The Financial Aspects of Accountable Care Organizations

4   The Applied Medical Home: A Recipe for Reform

5   ACOs: Fraud & Abuse Waivers and Analysis

6   Tax Implications of Accountable Care Organizations

7   Health Information Technology Issues for ACOs

8   ACOs and Their Antitrust Implications

9   Performance/Quality

10   Certification and Licensure

11   Governance and Management

12   ACOs and State Insurance Laws

13   How State Law Issues May Affect ACOs

14   Merit-Based Savings Distribution Models for Accountable Care Organizations

15   Physician Compensation Valuation in an ACO

16   Capital Formation and Value Metrics of ACOs

17   Post-Acute Providers

18   ACOs at Academic Medical Centers

19   Specialty ACOs: Pediatric ACOs for Medicaid Patients

20   Beneficiary Assignment: For Whose Care Is the ACO Responsible?

21   ACO Compliance Planning: Considerations and Opportunities in an Emerging Regulatory Environment

22   Commercial Accountable Care Organizations: Experimentation and Best Practices

23   Accountable Care Organizations in the Medicaid Context: A Sixteen State Comparison

24   ACO Best Practices

25   Private Payer and Physician Perspectives on ACO Collaborations

26   ACO Credentialing