Week 11 Discussion Qestions

| October 22, 2018

Discussion
Question # 1
The reading assignment for this week
“Emerging Medicaid Accountable Care Organizations: The Role of Managed
Care”, examines efforts
by a number of states to set up Accountable Care Organizations (ACOs) within
their Medicaid programs. An ACO is a provider-run organization in which
participating providers are collectively responsible for the care of an
enrolled population, and may share in any savings associated with improvements
in the quality and efficiency of care. The structure of Medicaid ACO
initiatives is influenced by individual states’ experience with managed care,
other existing care delivery arrangements within Medicaid, and the challenges
of serving low-income and chronically ill populations. Cost-containment also is
a motivating factor, and states must balance short-term cost-containment
pressures against the investments in partnerships and delivery system redesign
necessary for the success of Medicaid ACOs over the longer term.
From the reading, list what you believe
will be the top 3 major benefits of Medicaid ACO models and the top 3
challenges of Medicaid ACOs.
Feel free to use
and cite supplemental resources to back up your viewpoint.

Discussion
Question # 2
Accountable
care organizations build on the managed care concept while eliminating some of
its drawbacks. In an ACO model, an organization assumes responsibility for
managing and coordinating the overall care of a population. By lowering costs
beyond expected rates and demonstrating improved health outcomes, ACOs received
a portion of the “shared savings” that are dispersed among the
hospitals, physicians and other providers in the ACO. In other words, ACOs have
an incentive to deliver results, unlike today’s fee-for-service model that has
driven up utilization and therefore costs.
For this
assignment you are a hospital CEO looking to develop the skills to become an
ACO or be in contract with an ACO. In order to move forward this plan,
please provide answers to the questions below:
1) Which
ACO program will you participate in and why (i.e. Pioneer ACO model)?
2) How
will you compete with other hospitals that have established ACOs first
(example: partnering with physician groups)?
3) What
types of technology and or services will you adopt or expand in order to
measure clinical outcomes that can be shared in real time?
4) What
other methods of training and preparation will you use to prepare your
hospital?

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