NCQA Offers ACO Accreditation Review
Thomas says that the organizations that meet accreditation criteria can show that they "look to find more efficient patterns of care that prevent people from ending up in the hospital or emergency room. They would be looking for opportunities to keep people from getting sick, rather than erecting barriers."
She adds, "hospitals are very dangerous places. It's a good thing to have your care managed outside the hospital and not end up in a crisis situation."
Measures that scrutinize an ACO's efficiency, utilization, and overuse will reflect how well providers avoid antibiotics in adults with acute bronchitis, unnecessary use of imaging studies for patients with low back pain, and will measure all-cause readmissions. Relative resource use or RRU measures expected in the future will look at costs for asthma, heart and lung diseases, diabetes and hypertension.
Surveys measuring patient experience will also be a component of the final score.
Those organizations receiving accreditation will be named on the NCQA website, Thomas says. Eventually, if the data is statistically strong enough, specific scores will be posted for each ACO. Still to be disclosed is the precise weight each of the NCQAs measures will have in determining an ACO's score.
- EHR Systems 'Immature, Costly,' AMA Says
- Anthem Blue Cross, 7 CA Health Systems Create New Challenger, Business Model
- Interstate Medical Licensure Effort Advances
- Better HCAHPS Scores Protect Revenue
- Data Points to Boom in Private HIX
- How to Build a Health Plan from Scratch
- CEO Exchange: Preparing for Population Health
- Narrow Networks Cut Costs, Not Quality, Economists Say
- Few Winners Among MSSP Participants
- Insurers see cost hikes in Partners HealthCare (MA) mergers