Alternative Payment Models: Business Perspective
Speaker: Pat Schou, Executive Director
Illinois Critical Access Hospital Network and Illinois Rural Community Care Organization
As critical access hospitals (CAHs) and small rural hospitals evaluate whether to participate in an alternative payment model (APM) as an option under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) for their medical providers, it is important for hospital leadership to evaluate the APM model from a business plan perspective. The APM model requires hospital and clinician integration which will impact reimbursement and how care is coordinated and managed in the both the hospital and practice setting. Pat Schou, Executive Director for the Illinois Rural Community Care Organization (IRCCO), a statewide rural accountable care organization (ACO), discusses the financial strategies IRCCO has undertaken to prepare hospitals and their medical providers for clinical integration. She shares how they measure the return on investment for the ACO as well as for the hospital and medical provider. Ms. Schou explains the advantages and disadvantages of an organization considering becoming a part of an APM.