The government is one of the largest purchasers of health care services and because of this, they seek out opportunities to contain costs. Recent health care policy has focused on managing costs while offering quality care and improving access to care. The Centers for Medicare and Medicaid Services (CMS) Innovation Center develops payment and service delivery models with this in mind.
Scenario
Mr. Magone, CEO of Healing Hands Hospital, has asked you to join the Future of Healing Hands Task Force. Your first assignment is to work with the hospital’s Chief Financial Officer (CFO), Ms. Johnson, and provide a summary of how the new CMS initiatives might impact the organization’s revenue structure. More information on the innovation models can be found on the CMS Web site.
Describe an Accountable Care Organization (ACO) and the benefits of an ACO.
Describe an episode-based payment initiative and the benefits of this initiative to Healing Hands Hospital.