Douglas Hastings, Chair of the Board of Directors of Epstein Becker & Green, P.C., will copresent “Accountable Care and Governance Challenges Under the Affordable Care Act” at The National Congress on Healthcare Clinical Innovations, Quality Improvement, and Cost Containment, which runs from October 26 to 28.
Health care provider organizations and the ACOs that they form or in which they participate in face a variety of challenges and opportunities in the Accountable Care Era. Provider entity boards and ACO boards will need to review their committee structures related to quality in order to ensure that the board or board committee’s charter requires attention to effectiveness, efficiency and patient-centeredness in addition to patient safety. ACO boards and ACO sponsoring organization boards also will need to ensure that appropriate and effective management and clinical personal and protocols are in place to meet CMS, NCQA, and other requirements and to achieve the ACO’s quality and financial goals.
The speakers will address the fiduciary duties of board members in implementing accountable care including: payment changes which will further reduce reimbursement to providers with poor scores on quality measures or who evidence inefficiencies such as above-average readmissions; the shift to various forms of pay-for-performance, bundled payments and global or population-based payments, or other value-based reimbursement methodologies which will require infrastructure investments by providers that may or may not be reimbursed, further threatening financial solvency; the increasing focus on quality measurement and reporting which may trigger fraud and abuse enforcement against providers making claims to public and private payers for care that is ultimately deemed substandard; greater quality data reporting and transparency which will require board oversight to assure that reporting is accurate; and compliance plans which will need to be enhanced to address these expanded concerns.
For more information, visit CostContainmentCongress.com.