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Accountable Care Organizations (ACOs) are physicians, hospitals, and other healthcare providers (nurses, dieticians, social workers, hospice, extended care) who provide qualitative coordinated care to their Medicare patients by coming together voluntarily. The goal of qualitative coordinated care is to ensure that patients get the right care at the right time while preventing medical errors and unnecessary duplication of services. 

An ACO aims to improve quality, reduce healthcare costs, and enhance the patient experience. When an ACO succeeds in delivering high-quality care and spending healthcare dollars more wisely, it will share the savings it achieves for the Medicare program. 

How does telehealth enhance the patient experience? 

An aging population, rising chronic illness, no-show woes due to transportation and time constraints, accelerating health costs, the significance of self-care, and new payment models are the driving factors behind telehealth. 

Telehealth may help address these situations to achieve value-based patient-centered care where providers get connected with patients across vast distances through remote monitoring, communication, and patient counseling. 

Even chronically ill patients may have phone or video sessions with the care team, where healthcare professionals monitor their patients' progress. 

The patients can also have access to their health records as well as receive focused education. 

How does Telehealth help in delivering high-quality care? 

  • The Centers for Medicare & Medicaid Services (CMS) have reported in the Medicare Shared Savings Program (MSSP) regulatory guidance that ACOs are capable of “coordinating care, such as through the use of telehealth, remote patient monitoring, and other enabling technologies.” This has produced significant savings on hospital admissions and readmissions, ER visits, and costly interventions by managing acuity through population health management in a proactive manner. 

  • Telehealth technology helps the ACO to identify at-risk patients and maintain close contact. 

  • Both specialists and the primary care physician can examine a patient at the same time. These interactions allow the primary care physician to make better decisions regarding the patient’s health over a period of time. 

  • Additional factors, such as medication regimens and health improvement habits, can be continuously monitored through timely virtual communications.


Is it possible to spend healthcare dollars wisely using telehealth technologies? 

  • Yes, the Centers for Medicare & Medicaid Services (CMS) pays for telehealth services since it can help ACOs achieve their goals they are striving for. With new waiver provisions by CMS, ACOs incorporate telemedicine into their overall operations and services.

  • Physicians are incentivized to use telehealth services under Medicare's new value-based payment models to utilize relevant CPT reimbursement codes. 

  • Remote delivery of healthcare services through telecommunications devices enables better care coordination among providers and care settings to keep people out of the hospital. 

  • An average estimated cost for in-person acute care is $136 to $176 whereas, it costs only $40-$50 for a telehealth visit, which can be reimbursed. 

  • CMS reimburses facilities originating a telehealth encounter a flat fee of $25, while the telehealth provider gets 100% of the fee-for-service facility rate. Patients’ co-pay amounts to 20% of the visit’s cost. 

  • Substitution of telehealth service for direct visits can annually save 5,718 in travel costs and $3,431 in lost wages for patients, plus $20,841 for the hospitals as per the NTCA– The Rural Broadband Association’s analysis. 


What are the criteria for the right telehealth solution? 

  • Telehealth solution should adapt to various tethered/untethered endpoints in addition to bandwidths. 

  • It should be robust and remain alive in case of server failure. 

  • It should be built on medical-grade network infrastructure with solid architecture. 

  • It should be more straightforward than a telephone to use. Single click collaboration should be incorporated widely to support its adoption.

  • It should be flexible to push or pull data to/from EMR’s. 

  • Telehealth solutions should allow the primary care physician and specialists to examine a patient simultaneously with vitals being shared with providers through various telemetry devices to promote cost-saving virtual care. 

  • Since the physicians are not always available, a telehealth solution should update caregivers' status to bring the available providers online. 


So, are you ready to accomplish ACO goals by adopting a telehealth solution? You can talk to our Hifinite team about its implementation in your practice. 


Can Telehealth help in achieving the goals of the ACO program?

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