Chapter 2: Why ACOs? How Can an Organization Produce Accountability? The Accountable Care Organization What Does It Mean to Be Accountable? Accountability for Quality Accountability for Cost Accountability for Clinical Integration Accountable by Whom and to Whom? Accountable Care Structures
Chapter 3: Structure and Organization: Putting an Accountable Care Organization Together Structure of Accountable Care Organizations Organizational Models for Accountable Care Organizations Qualities of Physician-Hospital-Led versus Physician-Led Accountable Care Organizations Building on Existing Infrastructure Network Building Physicians within the Accountable Care Organization Employed Physicians versus Independent Physicians Disruptive Effect of Volume to Value Interactions with Health Plans Accountable Care Organizations: Legal Considerations Antitrust Medicare Shared Savings Program Participation in Federal Health Care Programs Anti-Kickback Statute Stark Law Civil Monetary Penalties Statute ACO Waivers Tax Exemption State Insurance Law Governance and Organization Physician Leadership in Accountable Care Organizations Baylor Scott & White Quality Alliance Governance and Organization Essential Baylor Scott & White Quality Alliance Committees Role of Evidence-Based Medicine How Data Drive Performance Care Coordination Will Accountable Care Organizations Work?
Chapter 4: Patient Experience of Care Responding to Consumerism through Accountable Care Organizations Activated Consumers Reference Pricing Wellness, Technology, and Self-Care Consumer Expectations about Access Retail Clinics and Access to Care Consumers Expect Patient-Centeredness STEEEP Care in Inpatient and Outpatient Settings 70% for Primary Care 20% for Specialty Care Shared Savings and the Patient Experience of Care Role of Hospitals in Population Health Integration between Hospital Care and Ambulatory Care
Chapter 5: Population Health Baylor Scott & White Quality Alliance Population Health Infrastructure Patient-Centered Medical Home BSWQA Specialists and Care Protocols Complete the Total Care Experience Care Coordination Care Coordination Workflow Motivational Interviewing Care Coordinator “Hot List” Workflows Transitional Care Data Analytics Data Analytics to Bedside Behavioral Health Value-Based Contracts Driving Improved Quality & Reduced Costs through Population Health Management Who Will Benefit from the Baylor Scott & White Health Care Model? Optimizing the Medicare Shared Savings Program to Drive Value-Based Care Proactive Customer Engagement: Using a Wellness Visit Business Model to Drive Population Health How the Wellness Visit Business Model Works Process Design Deployment Using a Wellness Visit Business Model to Transform Health Care Information Technology: Promoting Population Health Electronic Health Record Health Information Exchange Population Health: Summary
Chapter 6: Financing Accountable Care Health Care Costs Improving Health Care Value by Reducing Waste Current and Future Role of Payers Financing Population Health Defining the Patient Population Sharing in Rewards for Improved Quality and Efficiency While Reducing Costs The “Why” Behind the BSWQA Shared Savings Bonus Distribution Employer-Financed Insurance and Insurance Design