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Accountable Care Organizations and Patient-Centered Medical Homes PowerPoint Presentation

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Description : This presentation on Accountable Care Organizations and Patient-Centered Medical Homes was created by the School of Pharmacy Relations Committee for AMCP. The objective of this presentation is to describe some issues regarding delivery and payment of healthcare services in United States, describe Accountable Care Organizations (ACO), describe Patient-Centered Medical Homes (PCMH), list the differences between ACO and PCMH.

Tags : Patient-Centered Medical Homes, School of Pharmacy, healthcare services, United States, Accountable Care Organizations, ACO, Patient-Centered Medical Homes, PCMH

Published on : Jul 01, 2020 | Views : 2323 | Downloads : 0

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Slide 1-

Accountable Care Organizations and Patient-Centered Medical Homes Created by the School of Pharmacy Relations Committee for AMCP Updated: February 2020
Slide 2-

Objectives Describe some issues regarding delivery and payment of healthcare services in United States Describe Accountable Care Organizations (ACO) Describe Patient-Centered Medical Homes (PCMH) List the differences between ACO and PCMH
Slide 3-

US Healthcare System Healthcare Chart. Joint Economic Committee https://www.jec.senate.gov/public/index.cfm/republicans/2010/8/america-s-new-health-care-system-revealed Accessed February 21, 2020
Slide 4-

US Healthcare System – Outcomes Text Text Text Text Text Text Text Text Text Text OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.
Slide 5-

US Healthcare System – Issues Fee-for-Service Model Providers until recently were paid based on the quantity and complexity of services provided Payment was not linked to outcomes No incentive for provider associated with patient outcomes Fragmented Care Delivery Seamless transfer of patient information is lacking Care navigation in the complex healthcare system is challenging for the patient Inefficient delivery of care and unnecessary services
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Innovative Models
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Accountable Care Organizations “..group of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients” - CMS CMS (2020). "Accountable Care Organizations (ACOs)." Retrieved February 21, 2020, from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/.
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Accountable Care Organizations Medicare Shared Savings Program ACO Investment Model Advance Payment ACO Model Next Generation ACO Model Pioneer ACO Model Commercial ACO Models Features Upside vs downside risk Access to capital upfront Percentage – risk/earnings sharing
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Patient-Centered Medical Home University of Washington. Accountable Care and the PCMH. Accessed on Feb 22, 2020 from https://courses.washington.edu/clininfo/chapters/chapter-8-accountable-care-and-the-pcmh
Slide 10-

Patient-Centered Medical Home NCQA (2018). "Patient-Centered Medical Home (PCMH)." Retrieved February 23, 2020, from https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/.
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Patient-Centered Medical Home PCMH-certification done by agencies like NCQA URAC Joint Commission Currently, 13,000 practices housing 67,000 clinicians are PCMH-certified 21 million beneficiaries receive care in PCMH-certified facilities NCQA (2018). "Patient-Centered Medical Home (PCMH)." Retrieved February 23,2020, from https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/.
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ACO vs PCMH
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Resources https://www.healthaffairs.org/do/10.1377/hblog20180810.481968/full/ https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/ https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO https://pcmh.ahrq.gov/page/defining-pcmh
Slide 14-

Thank you AMCP Member Pranav Patel for creating this presentation
Slide 15-

To improve patient health by ensuring access to high-quality, cost-effective medications and other therapies. Mission & Vision

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MattB

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