Main Library See More- Visit ACOExhibitHall.com
Solving the ACO’s Out-of-Network Utilization Problem

Solving the ACO’s Out-of-Network Utilization Problem

March 29, 2021Jacqueline LaPointeNo CommentsRevcycle IntelligenceNext Generation ACOs

March 29, 2021 – Physician networks are key to the success of accountable care organizations. Leaders of these organizations, otherwise known as ACOs, lean on their networks of high-quality, cost-efficient providers to improve patient outcomes, reduce costs of care, and achieve shared savings.

But patients don’t always stay within cultivated high-performing networks, creating quality and cost problems for even the best ACOs.

“Historically, we were seeing only roughly about 42 percent of the services from our population coming in-network,” Tyler Munson, senior vice president of operations at Southwestern Health Resources, recently told RevCycleIntelligence.

Flipping that statistic around, Munson said that means a majority of patients treated by the Texas-based clinically integrated network and its ACO providers were receiving out-of-network care.

SWHR’s ACO is one of the nation’s top-performing Next Generation ACOs. Its Southwestern Health Resources Accountable Care Network saved more than $52 million in 2019, accounting for a fifth of total program savings that year and bringing its individual ACO savings to $120 million since joining the program in 2017.

Full Article

: leakage, Referrals

Related Posts

Bridging the EHR Divide. Helping ACOs and CINs Overcome Communication Challenges

April 1, 2020Garrett Schmitt

Out-of-Network Primary Care Tied to Rising ACO Costs

February 18, 2020Garrett Schmitt

Create Value for Consumers by Leveraging ACO Provider Choice

July 11, 2018Garrett Schmitt

Leave a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Recent Posts

  • Reinventing Community-Based Healthcare Delivery in a Value-Based Landscape
  • FLASH INTERVIEW — CareJourney
  • To Sustain The Value Movement, Make Next Generation ACOs A Permanent Option
  • FLASH INTERVIEW — eMedApps
  • FLASH INTERVIEW — Innovista Health Solutions
 
Solving the ACO’s Out-of-Network Utilization Problem
  • MENU
    • Main Lobby
    • Vendor Halls
    • Our Team
    • Newsletter
    • Exhibit With Us
    • Testimonials
    • Board Room
    • Live Events
    • Library
    • Contact Us