Payers and providers looking to operate through an accountable care organization (ACO) will require to adhere strictly to state and federal laws regarding the development of this model of care. Accountable care organizations are responsible for the quality and cost of care among a certain patient population and must abide by the laws and regulations that the federal government has passed in terms of ACO development.
Review state laws for ACO management
The National Law Review also discussed the significance of adhering to state laws with regard to operating an accountable care organization. There are several decisions that need to be made when forming an accountable care organization including who can employ physicians and the type of control that can be exerted between payers and providers operating an ACO. all of this directly relates to state laws and healthcare regulations.
Invest time and commitment
Along with abiding by federal and state laws, there are various measures that accountable care organizations can take to ensure success in the healthcare market. It is essential to invest the time and remain committed when operating accountable care organizations in order to reap the cost savings of such endeavors.
Pursue risk-based payment contracts
In case to reach the shared savings and obtain the revenue needed to maintain a successful ACO, it is beneficial to invest in risk-based payment arrangements with payers, stated Mark Wagar, President of the Heritage Provider Network.
“While they require to be careful about assuming more risk, I consider the greatest thing for ACOs is to be more aggressive,” Wagar explained. “There are too many healthcare agencies with potential that are sitting on the sidelines and saying ‘Let’s do just share savings because we can’t lose. We will bill for fee-for-service and if we happen to make better things, we get a bonus but otherwise, we don’t lose.’”
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