OSF HealthCare has many accountable care relationships established by the Centers for Medicare & Medicaid Services (CMS).
Just like its name implies, accountable care holds health care organizations accountable for specific levels of quality care. The quality goals are defined by a payor and agreed to by identified providers of care.
How It Works
With an ACO model, OSF is assigned a specific number of Medicare beneficiaries. If the provided medical cost is greater than target, OSF will pay CMS a shared risk fee. If the provided medical cost is less than the target, CMS will pay OSF a shared risk fee.
In addition to risk-sharing for the defined population, an Accountable Care Organization (ACO) also encourages:
- Evidence-based and coordinated care
- Patient engagement
- Robust quality and cost tracking and reporting
What Does This Mean for Providers?
- Opportunities to provide better and more coordinated care from different providers, locations and levels of care to the patients we serve
- Opportunities for higher quality and improved outcomes
- Opportunities to provide patients with a better overall experience
- The utilization of home health, hospice, and long-term care services will minimize unnecessary hospital admissions and re-admissions.
- Will reduce length of stay and improve care coordination among different providers
- Will identify and coordinate social and behavioral health services by using care managers and others
Opportunities to Serve
When health care providers actively participate in the ACO and encourage their patients to do so, a higher quality overall patient experience will be achieved and our mission to serve our patients with the greatest care and love in a community that celebrates the gift of life will be fulfilled.
- Better care – from a holistic approach
- Improved value to the patient
- CMS Quality Metrics (PDF - 2 MB)A focus on quality
- A focus on improved patient experience
Simply put, through the ACO model, we can achieve CMS goal of the Triple Aim:
- Better health (for populations)
- Better care (patient experience and outcomes)
- Better cost containment (goal is to lower cost of health care)