How to manage ACO cash flow and reap Medicare Shared Savings rewards

Many early Medicare Accountable Care Organizations (ACOs) are experiencing cost-flow challenges and data problems, reports Healthcare Payer News. ACOs need healthcare IT solutions to track and demonstrate the quality of their provider healthcare and care delivery costs, but IT healthcare solutions are often very expensive and require with a huge upfront investment. By gaining insight into their provider practices and mining the data from EHRs, claims, labs and pharmacy benefits, ACOs can focus their physicians on cost-effective care and share data to reduce unnecessary costs, such as duplicate lab requests and unnecessary hospitalizations. Unfortunately, a high upfront IT investment does not ensure an ACO will earn shared savings rewards. In fact, only 29 out of 114 ACOs earned shared savings.

Excessive upfront investments create cash-flow difficulties and ROI

National Association of Accountable Care Organizations (NAACOS) surveyed healthcare organizations to determine that startup costs averaged $2 million for 35 of the first-generation Medicare Shared Savings ACOs that began in 2012. Individual ACOs put up investments ranging from $300,000 to $6 million and some took on substantial debt to fund their start-up costs. Certainly these provider groups are committed to the success of their ACOs and their healthcare IT technology solutions, so where did they go wrong? Can your ACO avoid the same situation and have a better and more profitable outcome? Absolutely. One of the biggest challenges experienced by these ACO was their large initial IT investments and the cash flow relief from Medicare ACO Shared Savings that then becomes necessary to pay for it. With such a huge upfront cost it is imperative to generate substantial savings, and fast. But is such a large investment really needed to be successful? There are multiple ways to deploy an ACO technology solution, some of which do not require such a large initial outlay.

How to lower your ACO start-up costs and increase cost control

Healthcare ACO technology solutions for payers and providers are acquired, delivered, used and paid for in a variety of ways. Finding the right solution can help Medicare ACOs and commercial ACOs make the transition seamlessly (and more profitably) from fee-for-service to value-based payment models. Recommendation:  Instead of traditional hardware purchases and custom onsite software development, a cloud-based ACO solution may better fit your needs. The upfront investment for ACO solutions to process and analyze ACO healthcare data varies widely by vendor, and can have a detrimental effect on cash flow. Recommendation: To manage cash flow while reaping the rewards of ACO analytics, look for a subscription-based ACO solution that reduces initial system costs and minimizes ongoing support costs. Subscription-based pricing can allow both small and large ACOs to find a cost-effective solution from the same vendor. Consulting fees for initial ACO system set up are also to be avoided. Pay-as-you-go pricing and turnkey cloud-based ACO software make unnecessary the custom builds and hordes of consultants who are often involved in the deployment of an ACO solution. Recommendation: Look for an ACO solution vendor that offers a ready-to-use data interface with custom mapping provided at no additional charge.

How Advalent develops cost-effective IT solutions

Advalent is bringing a new level of affordability and certainty to healthcare IT by:

  • Using standards-based design and implementation for software development at lower cost
  • Offering default implementation patterns for turnkey use
  • Minimizing up-front costs and maximizing cashflow
  • Providing configuration that allow customization to your unique business needs with the flip of a switch
  • Putting you in control for complete, accurate and timely submission for maximum rewards
  • Predictive analytics keep you up-to-date on the status of your cost-savings programs

What’s more, we let you try before you buy – at no cost. Free yourself from high upfront IT implementation costs for ACO technology. Sign up for a demo and free trial today and experience the Advalent ACO Solutionfor yourself.