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ACO's.....

  1. #1
    Default ACO's.....
    Exam Training Packages
    Hello All:

    This afternoon, I was asked "What do I think about EMR's" and the coders role? I responded that I do believe coders will still be needed regardless if a practice has an EMR. I was then told that " a coders role will be eliminated, don't you think"? I said no.

    The conversation quickly turned to "how can we utilize coders for ACO's". This person thinks we as coders should start to concern ourselves with this type of work and stop focusing on e/m's because as it was put to me " providers are going to start being paid based on patients disease/ disease process and the outcomes.

    I honestly haven't really thought too much about ACO's although I know its' an up and coming trend in the insurance world.

    So I pose a question to the rest of the coding world ( per se) What do you think the impact of ACO's will have on coders? Will this change our work process/focus from fee for service?

    Just looking for some opininons/thoughts....
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  2. #2
    Default Regarding The ACO Initiative
    Hello Fellow Coder,


    Funny you should address the subject of ACOs and the role of the coder. Ironically, a few months ago just too see what response I would get I applied to join an ACO start-up here in the midwest.

    I received no response.

    Regarding new business models in the healthcare industry, while I feel that coders can play a major role they would still be models that we to would have to learn and disseminate the value we can bring to the table. In closing, keep in mind fellow coders that when it comes to the business side of healthcare, there are other roles we can play other than just-"Coders."

    J. Aaron
    Illinois

  3. #3
    Default
    J. Aaron:

    I guess my question really is " what role" would we actually play? How would we be utilized, I have no issue with change per se but I am just more interested in what we can do as coders being part of the ACO world.

    In my current role, I don't technically code, from time to time I do but not on a daily basis. I am more on the Compliance side and thru my travels in the medical field, I realized several years ago that we as coders have many differant paths we can go down.

    Thanks for your input J Aaron, I appreciate the response.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default Accountable Care Organizations
    First ... I think we need to define what an ACO is (or is intended to be).

    There's a good article here:
    http://www.npr.org/2011/04/01/132937...ions-explained

    I don't think it will reduce the need for coders at all. You will still need some way of tracking the services provided to the patient, and using the CPT codes is the easiest way of doing that - even if you won't be paid "per service provided."

    Just my opinion,

    F Tessa Bartels, CPC, CEMC

    p.s. I have no faith at all that ACOs will do anything to reduce healthcare costs. It sounds suspiciously like the roll-out of HMOs back in the '80s. In my opinion, it will mostly result in more consultants making more money.

  5. Default Accountable Care Organizations
    Benchmarks created by CMS use HCC risk adjustment conditions to determine the success or failure of the ACOs. That said the need for risk adjustment coders will and is increasing.

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