Clinical Integration & ACOs

Clinical integration and accountable care organizations (ACOs) are really two sides of the same coin. These new words define how to think and act to become more effective and efficient in delivering value-based care. Clinical integration is the process – or the “way” – and an ACO is the structure. We help you define the “why, how, and what” needed to become clinically integrated and the ACO structure to support integration. Our approach considers the unique internal characteristics and culture of your medical community and hospital as well as your competitive and payer environment.

Our team members have assisted many clients with successful applications to the Medicare Shared Savings Program, strategies for and implementation of commercial ACO participation, and Medicaid risk arrangements. Our services include gap assessment and implementation, shared savings program development, payer/health plan strategy, clinical metrics design and performance standards, and provider contracting and incentive program design.

What makes us different? We have implementation experience. Our team includes individuals who led the implementation of some of the largest clinically integrated organizations. Our team members can help navigate the various regulatory requirements of Federal Trade Commission. We have the practical expertise in aligning and leading physicians, coordinating and managing clinical care across a continuum, designing and integrating the IT supporting care management, negotiating with payers, and managing risk pools and the financial operations specific to a clinically integrated organization. Many members of our senior management team have served in clinical leadership roles in managed care environments. Our team members have implemented numerous ACO/clinically integrated clients in care model development that takes full risk for Medicare Advantage lives in different markets, our multidisciplinary team has firsthand experience and success with ACOs.

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