13 Hot ACO Buzzwords All Providers Should Know
11. Domain. How CMS categorizes the 65 quality metrics whose scores will be basis for determining shared savings of up to 60%, r 65% if the ACO includes federally qualified health centers or rural health centers.
There are five domains.
- Patient or caregiver experience, which includes seven measures.
- Care Coordination, which includes16 measures.
- Patient Safety, which includes two measures.
- Preventive health, which includes nine measures.
- At-risk population/frail elderly health, which includes 31 measures. This domain focuses on six categories of health conditions or status: diabetes, heart failure, coronary artery disease, hypertension, chronic obstructive pulmonary disorder and frail elderly.
12. ACO Professional. This is a physician/osteopath, physician assistant, nurse practitioner, or clinical nurse specialist and not limited to those dedicated to primary care.
13. Eligibility. The proposed rule says that the following groups are eligible to participate in an ACO:
• ACO professionals in group practice arrangements.
• Networks of individual practices of ACO professionals.
• Partnerships or joint venture arrangements between hospitals and ACO professionals.
• Hospitals employing ACO professionals.
• Other groups of providers determined to be appropriate by the Secretary of Health and Human Services.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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