ACO Financial Analysis
Client/Profile
PHO associated with a major New England tertiary care hospital
Challenge/Situation
To help the PHO decide whether to pursue a Medicare ACO, using a process that engages physicians and hospital leaders in the analysis.
Process
Veralon conducted a series of interviews to determine the PHO’s readiness for accountable care. Capabilities were compared to ACO requirements to identify areas requiring further development. Veralon developed a financial model to estimate revenues and expenses for the PHO’s potential ACO, as well as potential shared savings for the physicians. Veralon also analyzed the net financial impact on the hospital, including the impact of reduced utilization.
Results
Based on Veralon’s findings the PHO has applied to become a Medicare ACO and is developing the additional required capabilities.