Healthcare Reform

Accountable Care Organizations are now operating nation wide. As they are in their infancy there is no one formula for success although the guiding principles are the same. I am sure many of you are unfamiliar with how these work and what your roles might be. R&L is uniquely positioned in this regard as we have been working with one of the first 112 ACO’s approved a full year before going live. In our second reporting year we are well on our way to achieving financial success. We also have operational responsibility for 3 of the 9 counties this organization works in.

There is considerable confusion with Exchange plans and how they fit with traditional managed care contracting. R&L with its strong Managed Care and credentialing expertise can eliminate the confusion and ensure you are contracted with those that make sense for you or eliminating contracts that do not.

Group practices that operate with one tax id but little meaningful integration are in jeopardy. R&L has the expertise to change the way groups operate both clinically and from the business side. This will be necessary to improve outcomes and the reporting of them. The fundamental change here is going from volume driven to value driven. Even patient satisfaction is a fundamental aspect of the changes. The ACO’s require an annual survey(administered by CMS) that is used as one of the measures to determine quality measure results which can affect reimbursement. Having worked with one of the largest healthcare satisfaction companies we have over 15 years of experience directly helping organizations excel at the patient experience which also improves the bottom line.