Population Health Management

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The Affordable Care Act (“ACA”) introduced numerous health care delivery models designed to improve quality of care and patient outcomes, increase efficiency, decrease health care costs and increase patient satisfaction with the health care experience.  These goals frequently can be achieved through “population health management,” a comprehensive, multifaceted approach to managing the health care of...Read More

The Affordable Care Act (“ACA”) introduced numerous health care delivery models designed to improve quality of care and patient outcomes, increase efficiency, decrease health care costs and increase patient satisfaction with the health care experience.  These goals frequently can be achieved through “population health management,” a comprehensive, multifaceted approach to managing the health care of groups of patients through the use of coordinated care across different provider types, electronic health records, evidence-based medicine and ongoing in-person and remote (e.g., telemedicine) monitoring/treatment of patients with chronic disease/complex medical conditions to prevent unnecessary hospitalizations and promote health and medical stability.

Population health management is being achieved through Medicare and commercial “shared savings programs” that utilize formally organized accountable care organizations (“ACOs”) to provide care and share achieved savings, as well as patient-centered medical homes, a health care delivery model in which patient care is coordinated through primary care providers (such as those staffing federally qualified health centers) who ensure that patients receive the right care at the time they need it, in the most appropriate delivery setting.  The CMS Innovation Center, also established under the ACA, is tasked with testing novel payment and service delivery models designed to achieve improved patient care at lower costs.

Hall Render attorneys advise on all aspects of ACOs (click here to see our ACO practice area description), patient-centered medical homes and other innovative care delivery models developed under the CMS Innovation Center and established as demonstration projects under the ACA.  Our attorneys understand that the health care industry is being transformed from a fee-for-service model to a shared savings/value-based purchasing mode, and we can assist hospital systems, ACOs and other providers to transition to population health delivery and payment systems.

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Areas of Focus

  • Accountable Care Organizations (ACOs)
  • Care Coordination
  • Medical Homes
  • Population Health Management
  • Risk-Bearing
  • Value-Based Purchasing