This is a first step toward implementation of an Affordable Care Act provision that cuts red tape in the health care system. HHS estimates this will save $12 billion over ten years. Whether a patient is eligible for coverage The status of a health care claim submitted to a health insurer
To protect against this high risk of significant financial loss, the Accountable Care Organization should plan at its inception for methods of payment and/or protection for these cases, such as secondary coverage (insurance).
Accountable Care standards may be fluid for some time, however it is clear that there will be a need for core competencies in population management, coordination of care and other areas for an ACO to function effectively. Blum emphasized that CMS will be looking for innovative models, with different payment systems, and with different “on ramps” to formation and approval. It was also acknowledged that improving quality and reducing cost through coordination of care will at times be at odds with and the Accountable Care Act’s continued focus on patient choice of providers.