Wellspring+Stockamp, Huron Healthcare Releases Healthcare Reform Briefing Focusing on Accountable Care Organizations

Thought Leadership Series Addresses Key Healthcare Reform Initiatives and Implications for Hospitals

CHICAGO--(EON: Enhanced Online News)--The Patient Protection and Affordable Care Act (PPACA) mandates Accountable Care Organization (ACO) pilots for Medicare to begin in 2012. And yet leaders of hospitals and health systems across the country are facing many uncertainties about how Medicare ACOs will operate.

“Changing the structure of healthcare reimbursement to promote quality and management of clinical utilization has the potential to fundamentally change the delivery system. If healthcare organizations effectively coordinate care and reduce unnecessary and duplicate services, healthcare costs could be reduced significantly”

The Centers for Medicare and Medicaid Services’ (CMS’s) main goals for the ACO mandates are to reign in healthcare costs and improve quality of care by increasing coordination among providers. However, Wellspring+Stockamp, Huron Healthcare experts say that there are still more questions than answers around the ACO model, including how to manage risk, how ACOs will be structured, and whether ACOs provide the right incentives for healthcare organizations to drive down costs and improve quality.

Under the Medicare ACO program hospitals, physicians and other providers that join an ACO will be reimbursed for services using the current payment system and rates. If the actual costs of care for the ACO’s defined patient group are less than the CMS established target and if quality requirements are met, then the ACO would receive and distribute a bonus to participating members. CMS has not defined any penalty for an ACO if the cost-of-care target is exceeded, so participants have an incentive to reduce costs, but no risk if they do not. This is one of the main reasons many in the industry are skeptical about the potential for Medicare ACO’s to be successful.

To help prepare healthcare providers, Wellspring+Stockamp, Huron Healthcare has released Key Healthcare Reform Initiatives: Accountable Care Organizations, which is a multi-part briefing series aimed at providing hospitals and health systems with the best practices for success in a post-healthcare reform reality. To view the full briefing: http://www.huronconsultinggroup.com/instance.aspx?instanceId=2453

Wellspring+Stockamp, Huron Healthcare executives offered the following insights and recommendations regarding ACOs:

“Changing the structure of healthcare reimbursement to promote quality and management of clinical utilization has the potential to fundamentally change the delivery system. If healthcare organizations effectively coordinate care and reduce unnecessary and duplicate services, healthcare costs could be reduced significantly,” said George Whetsell, managing director, Wellspring+Stockamp, Huron Healthcare.

“One way we’re seeing hospitals successfully engage physicians is to develop an internal ACO-like pilot initiative with a limited patient population. A real live, actual, limited-scope opportunity to work with doctors around specific categories of care gives both physicians and hospital executives the chance to test the process of building consensus around standards of care delivery. This will provide a chance to strengthen relationships, and make adjustments and improvements in care coordination efforts,” said Robert Wilson, managing director, Wellspring+Stockamp, Huron Healthcare.

Regardless of whether ACOs become a standard operating model, strong relationships between care providers will be essential for success in executing coordinated care. Building processes and an infrastructure in which existing relationships can flourish and new relationships can form will help executives learn how to optimize their care coordination efforts.

To receive a copy of Huron’s Healthcare Reform briefing series or to speak with one of the Wellspring+Stockamp, Huron Healthcare experts about healthcare reform initiatives or other issues affecting hospitals and health systems, please contact:

Jennifer Frost Hennagir
312-880-3260
[e-mail]

Jenna Nichols
312-880-5693
[e-mail]

About Wellspring+Stockamp, Huron Healthcare

Wellspring+Stockamp, Huron Healthcare, which is led jointly by Gordon Mountford and West Johnson, partners with clients to provide comprehensive performance improvement solutions that improve quality, increase revenue, reduce expenses, and increase physician, patient, and employee satisfaction across the healthcare enterprise. Clients include national and regional integrated healthcare systems, leading academic medical centers, community hospitals and physician practices. Wellspring+Stockamp resides in Huron Consulting Group’s Health and Education Consulting segment. This segment accounted for nearly 60% of Huron’s revenues for the full year 2009. Modern Healthcare ranked Huron Healthcare third on its 2010 list of the top 15 largest healthcare management consulting firms.

About Huron Consulting Group

Huron Consulting Group helps clients in diverse industries improve performance, comply with complex regulations, resolve disputes, recover from distress, leverage technology, and stimulate growth. The Company teams with its clients to deliver sustainable and measurable results. Huron provides services to a wide variety of both financially sound and distressed organizations, including leading academic institutions, healthcare organizations, Fortune 500 companies, medium-sized businesses, and the law firms that represent these various organizations. Learn more at www.huronconsultinggroup.com.