Accountable Care Organization

Accountable Care Organization
Accountable Care Organization
When the Affordable Care Act was passed in 2010, ECRH chose to adopt the one-sided accountable care organization model (ACO).
As a result of the failure of this partnership, ECRH has decided to exit the ACO business.
They are concerned, however, about the public perception of this choice.
The terms of the termination are being discussed, with the goal of determining how to minimize the public perception of termination, especially given how much marketing they did to get involved in this enterprise.
The government’s regulatory regulations governing the date of ending an ACO venture complicate this option even further.
Medical Home for Primary Care
The employed primary care group has been instrumental in establishing accredited primary care medical homes in all of the ECRH system’s primary care offices.
This effort is a promising new strategy for ECRH.
It has also been an appealing pull for Greenbranch Medical Center residency program family practitioners because Greenbranch has developed an accredited medical home for their family practice residency program.
Status of the American Nursing Credentialing Center (ANCC)
ECRH has been working hard to achieve magnet status for ERMC.
As an initiative, this effort has come to a halt.
Some of this can be attributed to the nursing leadership at ERMC.
This priority will be moved up in the organization’s goals by the CEO.
Technology of Information
ECRH has made significant investments in their information technology infrastructure.
This investment became necessary simply to collect the data required for ACO development.
This cost has risen far over expectations.
EPIC was fully integrated as ECRH’s principal information technology system.
Since the ECRH was functioning on different systems prior to the decision to consolidate to a single platform, there have been implementation issues.
EPIC installation necessitated extensive retraining for both staff and physicians.
The data conversions have gone smoothly.
The issues have been more human-related in comparison to the system’s effective application.
One of the primary concerns has been ECRH’s failure to achieve meaningful use criteria, which has resulted in significant income loss for the organization.
ECRH is facing legal action.
Inquiry by the Federal Trade Commission
Antitrust concerns have been raised as a result of the merger and acquisition of NMHC.
It has been discovered that ECRH controls 60% of the cardiology market and 52% of the oncology market in the service lines of cardiology and oncology.
Chestnut Care has been effective in diverting patient volumes to ERMC in various markets.
Union representatives from many trades were important in bringing this probe to fruition.
At the time this issue was raised, the President and the Executive Branch of the federal government were strongly pro-labor, which explains their interest in pursuing it.
Because of the market share control in oncology and cardiology, it is expected that a negative finding will be made in this case.
This could force ECRH to sell its stake in the Chestnut Care insurance business.
Another possibility is that certain NMHC hospitals be divested.
It is unlikely that both determinations will take place.
To avoid an investigation into this accusation, ECRH has spent a significant amount of money on this issue.
Predatory Collections and the Loss of NMHC’s Non-Profit Tax Status
The NMHC agreed to continue operating independently.
The consortium’s leadership established policies that included aggressive collections for patients served in NMHC facilities.
An investigative reporter interviewed an elderly woman who had her home stolen from her to pay for her medical debts in a recent evening news program.
This house has been in her family for more than a century.
This story prompted the state Attorney General’s Office to look into ECRH and NMHC’s abusive collecting practices.
The state has already adopted an aggressive position in investigating the status of non-profits that are not meeting regulations (e.g., charity care, research, and education).
The state is in financial distress and is looking for revenue wherever it can be found.
The prospect for the Attorney General’s Office’s anticipated final ruling is bleak.
If NMHC is obliged to pay taxes, the bottom line for these hospitals would be wiped away, and many of the critical services provided by ECRH to the destitute population will be decreased or terminated.
Faith and Principal Consultants Report
ECRH recently hired Faith & Main to do a market research study on their women’s services.
The following is a summary of Faith & Main’s results.
Cross-County Interest in a Women’s Center
36 percent of women in the service region would go across county boundaries to receive high-quality women’s health care.
72 percent of women in Chestnut County would consider using East Chestnut Regional Medical Center’s women’s services.
Women in all counties expressed the most interest in these services:
Breast health
Services in general gynecology
Female physicians
Services in a single field
Women’s physicals
Heart Care and a Health Information Line are of particular interest.
A physician-recommended source of information
A nurse help line that could serve as a resource for women’s heart health treatment as well as a source of health navigation.
Appointments with Their Primary Care Physician: Specific Expectations
Women anticipate same-day appointments.
Women placed this in the top 28.7 percent from the collar counties to Chestnut County.
Women in Chestnut County ranked this in the top 37.7 percent.
Women of reproductive age had the highest expectation of same-day appointments.
Percentage of those expecting same-day appointments
42.9 percent of Chestnut County women of childbearing age are pregnant.
31.3 percent of collar county women of reproductive age are pregnant.
Willingness to be Seen by a Nurse Practitioner: “Yes”
75.7 percent of Chestnut County women of childbearing age are pregnant.
76.1 percent of collar county women of reproductive age are pregnant.