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The recently passed Affordable Care Act has created a new mechanism for incentives known as Accountable Care Organizations (ACO). In order to meet compliance of an ACO and realize the revenues associated with shared savings from Medicare, provider groups must accept a shift away from fee for service to pay for performance. Better performance means the ability to improve disease outcomes for patients, especially as it relates to chronic conditions and elder care. By allowing for evidence-based care and care coordination, healthcare systems and health professional performance will achieve significant quality improvements.
Adopting the ACO model requires the understanding that taking advantage of shared savings will require a shift towards better coordination of care and evidenced-based clinical care. Promoting preventive medicine in order to avoid costly acute episodes, especially as they relate to chronic disease, elder care, and within health disparity communities, will lead to better outcomes for patients. Such a system realizes cost savings through the ability to move to a performance-based model and limit errors and redundancies, all while maintaining compliance. Addressing this cost curve requires disease management solutions that can tailor care regimens, distribute care to patients, and promote evidence-based clinical practice. In addition, to reach the full organizational goals as outlined by CMS requires that organizations have the ability to integrate data from multiple sources, including from healthcare systems, community health providers, health centers, and individual physician practices. CTIS’ experience and competency as a systems integrator, coupled with custom solutions design and development, allows for meaningful information to be delivered and presented to stakeholders.
