In a healthcare industry that is shifting from fee-for-service to value-based-care models, it’s increasingly important for practices to understand everything about their costs. To that end, Centers for Medicare and Medicaid Services (CMS) delivers a claim file to Accountable Care Organizations (ACOs). Unfortunately, ACOs often don’t take full advantage of the intelligence available within the CMS claim file. But if ACOs can unlock these “mysteries” held within the file, they can reduce costs more quickly. Here are just a few examples: Where do all my patients receive care? Your CMS claim file can show you where your patients are actually receiving care. The answer may surprise you. For example, we helped one of our ACO clients in the rural Midwest plot on a map where its patients were receiving care. As expected, patients received a lot of care in the […]

How can healthcare organizations that were built on volume adapt to the arrival of a value-based reimbursement system?  To help answer that question, we’re continuing our four-part series of posts based on a new white paper by Allscripts Chief Medical Officers Doug Gentile, MD and Toby Samo, MD exploring the unique perspectives of pioneering Accountable Care Organizations. In this fourth and final part of the series, Drs. Gentile and Samo explore how ACO’s manage their relationship with patients, and conclude with some parting advice from the pioneers.  To read the white paper in its entirety, go to www.allscripts.com/ACOwhitepaper.    Patients   Key Takeaways:   Invest in the sickest Ensure social media informs physicians first Patient Mobility Improves Customer Service  For many, the Achilles’ heel of the ACO concept is consumer involvement. Healthcare is the only industry in which the consumer has an indirect […]