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ACO Development and
Management

The Affordable Care Act passed by Congress in 2010 established a program that is intended to encourage providers of services and suppliers (e.g. physicians, hospitals and others involved in patient care) to create a new health care entity called an Accountable Care Organization (ACO). Through this entity, providers agree to be held accountable for improving the health and experience of populations while reducing the rate of growth in health care spending. While the original intent is to offer a Shared Savings Program for Medicare beneficiaries through the ACO, it is expected that commercial insurers and state Medicaid programs will follow suit with similar value-based purchasing programs.
 
Eagle Run Managed Care has the depth and experience to assist your organization in the following aspects of ACO Development and Management:
 
    Organization structure analysis and readiness for an ACO contract, including:
      -    Governance requirements
      -    Provider delivery system gap analysis
      -    Ability to manage chronic care needs of a diverse population
      -    Information system capability across the delivery system
      -    Willingness for performance-based contracts and payment
    Provider network development and partnership contracting
    Support in the following:
      -    CMS Application Development
      -    Support in commercial insurer negotiations
      -    Program implementation (medical management programs, network
           engagement, member communication and outreach)
      -    Program compliance and performance monitoring

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