An accountable care organization (ACO) is a healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned group of patients. Accountable Care Organizations: Value Metrics and Capital Formation explores the historical background and evolution of the ACO model as the basis for the development of the value metrics and capital formation analyses that are foundational to assessing the current efficacy and capacity for change.
The book examines the four pillars of value in the healthcare industry: regulatory, reimbursement, competition, and technology in addressing the value metrics of ACOs, including requirements for capital formation, financial feasibility, and economic returns. It focuses the discussion of non-monetary value on a review of aspects of population health within the context of such objectives as improved quality outcomes and access to care.
• Explains why ACOs might be the cost-containment and quality improvement answer the industry has been looking for
• Describes the circumstances and capital structures where ACOs represent a sound investment
• Includes a foreword by Peter A. Pavarini, Esq.
The book examines the positive externalities of the ACO model, including results for third parties outside the basic construct of the ACO contracts shared savings payments. It also discusses the potential role and opportunities for consultants in assisting their provider clients in the consideration, development, implementation, and operation of an ACO.
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- Outlines the historical background and evolution of the ACO model as the basis for the development of the value metrics and capital formation analyses that are foundational to assessing the current efficacy and capacity for change
- Focuses the discussion of non-monetary value on a review of aspects of population health within the context of such objectives as improved quality outcomes and access to care
- Addresses the value metrics of ACOs, including requirement for capital formation, financial feasibility, and economic returns
- Examines the positive externalities of the ACO model, including results for third parties outside the basic construct of the ACO contracts shared savings payments
- Includes a foreword by Peter A. Pavarini, Esq.
- Presents a brief discussion of the potential role and opportunities for consultants in assisting their provider clients in the consideration, development, implementation, and operation of an ACO
Reviews from the Experts
"Although many authors, including the one writing this foreword, have previously attempted to explain the ACO concept in practical terms, virtually no one thought to thoroughly analyze the financial underpinnings of this model until Bob Cimasi decided to write this book. What an ambitious work it is! Even though most existing ACOs remain gestational or in their earliest years of operation, Mr. Cimasi and his associates at Health Capital Consultants have managed to assemble an authoritative body of information on this rapidly evolving subject and to present their findings in an easily understood manner. Together with many of my colleagues in the American health law bar, I have long respected Bob Cimasi’s passion and talent for unraveling complex healthcare equations and objectively assigning value to all or part of a business or relationship. That was difficult enough to do in a traditional fee-for-service environment; it will be much harder as the nation transitions to shared savings, bundled payments and other new methods of value-based purchasing. With the publication of Accountable Care Organizations: Value Metrics and Capital Formation, readers will now have insight on the principles and methods Mr. Cimasi and his team of experts carefully use to appraise transactions within a changing healthcare payment and delivery system. This text is much more than a compilation of educational resources on a currently hot topic. Rather, it could become a seminal work relied upon by all stakeholders in a transformed healthcare marketplace. I cannot think of anyone more qualified than Bob Cimasi to take on such a daunting task. It is always a privilege to be asked to read a manuscript before it becomes publicly available. This time, however, I found reading Accountable Care Organizations: Value Metrics and Capital Formation to be like looking through a window on a brave new world. I found myself asking: is this finally the way Americans will learn how to assure quality, efficiency and fairness in one of the most important aspects of their daily lives? I hope the readers of this book will be challenged to ask that same question as they seek to understand the ins and outs of ACOs.”
- Peter A. Pavarini, Esq Partner, Squire Sanders (US) LLP
“Bob has done it again. As a thought leader in contemporary healthcare matters, his new book, Accountable Care Organizations; Value Metrics and Capital Formation, establishes and explains in plain terms the operational and financial DNA and genomic construct and understanding for any organization considering the development and operations of an ACO. A must read and resource for any healthcare industry executive.”
- Roger W. Logan, MS CPA/ABV ASA; Senior Vice President, Phoenix Children's Hospital
“To my knowledge, “Accountable Care Organizations” is the first comprehensive text on capital formation and value metrics for this new healthcare business model. And, I can think of no one more qualified to write it than Robert James Cimasi of Health Capital Consultants. I am sure it is destined to become a classic work. My suggestion is to read, review, refer and profit by this valuable resource.”
- Dr. David Edward Marcinko, FACFAS, MBA, Certified Medical Planner
“As both a healthcare management educator and as a consultant who has worked on health and professional services transactional advisory work for many years, I applaud your ambitious undertaking. Your description of the complex history and evolution of the US health system provides a useful framework for students and professionals who may lack a detailed background in the field. This should help them better understand both how we have arrived at the ACO approach, and how it might work. Your addressing capital and valuation information is also uncommon in the literature on ACOs. It should provide a valuable contribution to the field, especially given that a some surveys of healthcare leaders have pointed to access to capital and to a lesser but still important degree, agreement on valuation, as concerns as they consider acquisitions, mergers, and other affiliations towards forming/joining ACOs or similar organizations to help deal with the changing reimbursement and competitive environment.”
- R. Brooke Hollis, MBA/HHSA, Executive Director, Sloan Program in Health Administration, Cornell University and Managing Member, Hollis Associates Acquisition Advisors, LLC