Accountable Care Organizations / Managed Care

Brought to the forefront by the 2010 Health Care Reform Act, the Accountable Care Organization model for delivery of health care will present opportunities for new models of risk management and financing.  This is because in order to qualify as an Accountable Care Organization an entity must have the following characteristics:

  • Management
  • P&L responsibility
  • Medical directors
  • Physical and financial infrastructure

In addition, within this new structure, we often find a new and more robust risk management function that is now responsible for the following:

  • Authority over membership within the ACO structure
  • Gatekeeper function
  • Credentialing policy for its member physicians
  • Creating common standards of care
  • Enforcing physician disciplinary procedures

We are experts in helping medical service provider organizations anticipate their new risk management needs and create specialty programs for:

  • Managed Care Errors and Omissions
  • Technology Errors and Omissions
  • Business Operations coverage for the ACO
  • Privacy coverage programs
  • Group Malpractice programs for member physicians
  • Group Business Insurance programs for member physicians
  • Stop Loss Reinsurance