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Homework answers / question archive / Running head: EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS Evaluation Plan for Accountable Care Organizations Name Institution 1 EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 2 Evaluation Plan for Accountable Care Organizations Introduction The healthcare system has assessed the effective strategies that would help in improving the delivery of efficient health services and the reduction of healthcare costs in the country

Running head: EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS Evaluation Plan for Accountable Care Organizations Name Institution 1 EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 2 Evaluation Plan for Accountable Care Organizations Introduction The healthcare system has assessed the effective strategies that would help in improving the delivery of efficient health services and the reduction of healthcare costs in the country

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Running head: EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS Evaluation Plan for Accountable Care Organizations Name Institution 1 EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 2 Evaluation Plan for Accountable Care Organizations Introduction The healthcare system has assessed the effective strategies that would help in improving the delivery of efficient health services and the reduction of healthcare costs in the country. The emergence of Accountable Care Organizations, health care payment methods, and delivery models has created a platform that will benefit the healthcare system (Blackstone & Fuhr Jr., 2016). The methods are aimed at improving the work of the health professionals and the medical institutions towards the success of the healthcare system. For instance, the Accountable Care Organizations (ACOs) are considered as the contracts and agreements between healthcare professionals and health institutions in reducing the health care costs as well as the implementation of strategies that are effective in improving the delivery of effective, efficient, and affordable care services (Palazzolo, 2015). The implementation of the ACOs in a healthcare institution will reflect the evaluation of its benefits to cost reduction and the improvement of the delivery of care services. The timeline will involve the assessment of the effective program, the contractual agreements, and the installation of the appropriate programs. Therefore, the evaluation plan will incorporate the project objectives, the evaluation methods, the measurement strategies, and the timeline suitable for the completion of the ACOs program. Project Objectives The implementation of Accountable Care Organizations in healthcare institutions is aimed at improving the delivery of care services and the reduction of healthcare costs. The project aims at introducing new payment systems as well as to reform the healthcare system through the coordination and collaboration of health professionals, health institutions, the federal government, and the healthcare stakeholders such as the policymakers (Palazzolo, 2015). Therefore, the project aims at the following objective; • Deliver seamless healthcare services • Provide high-quality health services • Improvise the system that will benefit the Medicare beneficiaries • Lower the costs of healthcare services • Improve patient safety • Enhance preventive care • Focus on the at-risk population • Care coordination • Involve theories that elaborate on the effectiveness of ACOs • Provide a timeline for the completion of the project Evaluation Questions i. What are the objectives and goals of implementing the ACOs? ii. What will be the benefits of implementing ACOs? iii. How will the healthcare system profit from the adoption of ACO programs? iv. How will the ACO program work? v. What will be the prerequisites of joining the ACOs? vi. What are the implications of professional liabilities after joining ACOs? vii. What are the ACOs’ quality measurement metrics? viii. Will the ACO monitor patient satisfaction? ix. What will the ACO involve in measuring its success? x. How will the change of implementing ACO affect healthcare organizational structure? EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 3 Evaluation Methods The evaluation of the effectiveness and the implications of ACOs in the healthcare system are based on the assessment of its benefits and its importance in delivering the desired and projected objectives. The evaluation plan will involve the aspects of assessing the data and success measurement strategies (Palazzolo, 2015). For instance, the data evaluation will involve the elements of assessing the costs and economic importance of the implementation of ACOs in healthcare institutions. The measurements of the success factors will also influence the aspects of implementing the ACOs based on the acquisition of the intended benefits. The benefits will be measured based on the reduced rates of Medicare expenses and the improvement of the delivery of efficient care services. Data Evaluation The aim of implementing ACOs in the healthcare system is based on the attainment of the intended objectives which reflect the improvement of the health service delivery and the reduction of the costs and expenses in health care. The modern ACA formation is considered different and influential when compared with the traditional care system. The modern approach has influenced the approaches of reducing the avoidable hospital admissions and shortens the hospital stays based on the improvement and the sharpening of the focus of the healthcare professionals. For instance, the readmission rates have reduced in the overall United States healthcare system by 6.3% due to the utilization of the ACO strategies (Blackstone & Fuhr Jr., 2016). Also, the rate of lengthy stays in hospitals has declined by 3.9%. The traditional methods had recorded a reduction of 3.8% of readmissions and 2.4% in the length of stays in medical facilities which indicates the drop in the rates after the emergence of the ACOs. The approaches and the data representation have identified the evidence of the effectiveness and efficiency of the implementation of ACOs in the healthcare system. The implementation of ACO has also been involved in the evaluation of the quality of care services rendered to the beneficiaries. The quality measures have been assessed and the benefits are deemed to help save the costs of healthcare services by Medicare program. The Medicare program through the implementation and adoption of ACO has managed to save $26.6 million within five years. The healthcare institutions that had implemented the ACO programs have benefited and have increased the rate of saving healthcare costs through Medicare from $26.6 million to $800 million in 7 years (Blackstone & Fuhr Jr., 2016). The success of the program, however, depends on the principles and collaboration of the health professionals and the management of healthcare institutions in reaching the targets set by the Medicare and policymakers in the adoption of ACOs. Healthcare professionals have the mandate of coordinating and enhancing their performance to attain the targets of reducing the costs of care and improving the delivery of care services. The implementation of the ACOs has also identified the effects of the program in changing the behaviors of the healthcare professionals (Palazzolo, 2015). Healthcare personnel are guided by the program in attaining the set of standards and requirements that are aimed at improving the delivery of care services. Therefore, the implementation of ACO in healthcare organizations will be effective in maintaining the strategies that are aimed at improving healthcare service delivery and the reduction of health costs. Evaluation Measures The approaches of measuring the success of the ACOs in healthcare institutions can depend on the strategies that are aimed at informing the institution about the elements of supporting the reduction of healthcare costs and the improvement of caser service delivery. The EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 4 strategies of measuring the effectiveness of ACOs can incorporate elements such as the expansion of the access of healthcare services, building of effective care teams, emphasizing on the wellness of the patients, and the use of high-quality data in informing the healthcare decisions. The expansion of access to care is an effective strategy for measuring the success of implementing ACOs (Fisher et al., 2012). For instance, healthcare institutions aim at improving the delivery of health services which could not be achieved by traditional healthcare practices. The procedures of improving access to care can involve strategies such as the availability of health services and the modification of the hours of accessing healthcare services such as when medical institutions open the facilities for 24 hours. Also, the strategies can involve the elements of increasing the primary care services in a medical facility. Primary care can include the services such as front door operations, general health practices, community pharmacy services, dental services, eye care services, patient education, disease prevention practices, health maintenance, counseling, diagnosis and treatment of acute illnesses, inpatient care, critical care, long-term care, home-care services, and daycare healthcare services (Fisher et al., 2012). The availability of primary and secondary health care services will broaden the medical practices in an institution and enhance the procedures of increasing the delivery of effective and efficient health care services. The health institutions using the ACO programs can also measure the effectiveness of the programs based on the evaluation of the time and extra hours worked by the health professionals. Health institutions should portray the presence of prolonged working hours and the availability of overtime whereby health professionals should modify their working schedules to accommodate the treatment of a large population of the patients in a single day (Fisher et al., 2012). The approaches will be effective in improving the delivery of health care services to cater for the needs of the families seeking health services from the medical institutions. Also, the health institutions using the ACO programs will evaluate the availability of medical professionals when needed. For instance, the health institutions should accommodate for emergency and urgent care where the health professionals should be available to improve the quality of life of the patients. The program, therefore, reflects the need for hiring emergency room physicians and part-time nursing specialists to improve the approach of saving the lives of patients in critical conditions. Moreover, building care teams would be effective in measuring the effectiveness and success of ACO programs. Building a care team will involve the approaches of involving nursing managers, a collaboration of health professionals, and work differentiation which will improve the delivery of care services to large populations in the community. Building an efficient health professional team will also involve the aspects of increasing the medical and clinical infrastructure, adding health personnel, and growing the medical facility equipment that is effective in improving the delivery of quality of care to the patients (Blackstone & Fuhr Jr., 2016). The creation of a care team will incur costs but the outcomes will be summative based on the benefits and the influence of the team towards the organizational objectives. For instance, an effective care team will focus on teamwork, goal setting, setting the bar, improved communication strategies, encourage respect and trust, determining to share of roles, assigning responsibilities, and learn more through collaboration (Fisher et al., 2012). The involvement and the creation of a care team will help a medical institution in focusing on the objectives of the ACO program as well as the focus on the strategies that would reduce time-wasting and improving the delivery of quality care services. Furthermore, emphasizing wellness can also be considered in measuring the effectiveness and efficiency of ACO programs in the healthcare system. Wellness is a measure of the success EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 5 of a medical program in the healthcare institution. Wellness is also the strategy of understanding and increasing the awareness of the health of an individual. Healthcare professionals have the mandate of involving patients in making viable decisions. Wellness can also incorporate the elements of having a healthy state of mind, mental stability, physical wellness, and social wellbeing. Health providers can as well involve the strategies that would measure and improve the wellness of the patients in a medical facility as well as in the community (Fisher et al., 2012). Emphasizing wellness will incorporate the practices that keep track of the quality metrics to each of the patients and evaluating the progress of recovery as well as the efforts and contributions of collaboration towards the improvement of the quality of health of the patent. Wellness can further be implemented by enhancing the approaches of increasing the annual wellness visits, patient satisfaction, reducing the gaps of health satisfaction, improved preventive cancer screening, weigh assessments, nutrition effectiveness, prenatal care initiatives, controlled high blood pressure, depression remission, asthma admission rates, asthma medication ratio, and the preventable emergency successes. Additionally, the use of high-quality data can be effective in measuring the success of the implemented ACO program. High-quality data is useful in informing health professionals concerning the approaches to making viable decisions that would improve the delivery of effective and quality health services. For example, medical institutions that have implemented the ACO programs will have benefits and advantages when compared to institutions that are using traditional methods (Blackstone & Fuhr Jr., 2016). The benefits will increase the approaches of improving healthcare service quality as well as reduce the health care costs which will attract the customers from the community. The health institutions will shift the referral strategies which will increase the rate of medical admissions based on the prospects of achieving customer and patient satisfaction. Also, high-quality measurement approaches will involve the evaluation of the domains that will be useful in understanding the effectiveness of the ACO program (Fisher et al., 2012). For example, chronic condition management can involve the measurement of the practices of controlling the high blood pressure, follow-up of the hospitalization of patients with chronic conditions, analysis of the poor control of mental illnesses, access to care composites, health plan surveys, presence of the ambulatory care services, the prevalence of drug abuse, primary care enrolment rates, childhood immunization programs, cancer screening practices, depression screening, effectiveness of contraceptive use, physical health assessment, and the accessibility of prenatal and postpartum care in the facilities. Measurement of specific medical practices can also be useful in evaluating the effectiveness of the ACO programs. Various approaches can be used to measure the success of ACO in a healthcare institution. For example, the healthcare institution can assess the approaches and the strategies of asthma medication ratio which are useful in the identification of the effective procedures employed by the health professionals in mitigating the problems of asthmatic conditions. Breast cancer screening and treatment practices can further be implemented to assess the effectiveness of the ACO implementation in a medical facility (Berkowitz & Pahira, 2014). Breast cancer screening is free services that are offered to the community in evaluating the prevalence of the disease in society and the efforts of the healthcare organization in preventing the spread and the effects of the disease on the patients. Cervical cancer screening can also be useful in analyzing the success of the ACO program in a medical facility. The cervical cancer screening will incorporate the aspects of evaluating the rate of screening services of the women in the community and the assessment of practices that are involved in educating women in reducing the risks of obtaining the disease. The rates of EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 6 controlling the high blood pressure, therapy sessions for cardiovascular diseases, ischemic vascular assessment, and the use of persistent Beta-Blocker Treatment of heart attack will be effective in measuring the success of the implementation of ACO in a healthcare facility. The assessment of the screening and cardiovascular regulation will improve the approaches to enhancing the strategic practices of improving or reducing heart failures and cardiovascular diseases (Berkowitz & Pahira, 2014). Also, behavioral health can be used in assessing the effectiveness of the ACO program. For instance, the evaluation of depression and mental disorder readmissions, depression clinical follow-ups, alcohol and substance abuse treatments will be effective in measuring the success of the ACO program and the efforts of the healthcare professionals in improving the delivery of quality health care services to the community. The availability of optimal diabetes care, comprehensive diabetes care, and statin therapy for diabetes can also be used in measuring the success of the ACO programs (Singer & Shortell, 2011). The success of the ACO programs in the healthcare institutions will reflect the evaluation of the success factors such as the improvement of the service care and the decrease costs of health services. Theoretical Approach to Implementing ACO Programs Accountable Care Organizations are considered effective in enhancing the improvement of care services and the reduction of the costs of healthcare services in a community. The implementation of ACO is aimed at forming the intended objectives and analyzing the inputs and the resources used in improving the healthcare system. The implementation strategy can be analyzed through the evaluation of Fisher’s Logic Model. The model elaborates on the theory of distinguishing the aspects of the formation, the implementation, and the operation of the ACO programs. Fisher further demonstrates the elements of collecting data that is relevant in forming the program, the elements of ACO contracts, and the structure of the program in enhancing and attaining the objectives of the healthcare system (Berkowitz & Pahira, 2014). The program also involves the approaches of evaluating the environmental contexts, the readiness of the organization, the implementation activities, the intermediate outcomes, and the impacts of the program in improving the healthcare system and the improvement of care service delivery. For instance, the implementation of the ACO program will reflect the need for the evaluation of the local context which is considered as the resource dependency theory. The resource dependency theory involves the evaluation of the efficiency of the healthcare institution’s stakeholders such as the suppliers, distributors, and investors in creating a platform that will improve the dependency and the success of the ACO program. The theory further demonstrates the aspects of utilizing ACO in improving the associations and collaborations within the healthcare institutions based on the elements of organizational behaviors, the certainty of health professionals, forming alliances, reduce dependency, and increase influence towards other health personnel in promoting organizational performance (Berkowitz & Pahira, 2014). Also, the local context and the resource dependency theory elaborate on the essential elements that would be effective in evaluating the possible impacts of implementing ACO in a healthcare institution. Furthermore, the implementation of the ACO program depends on the nature of the contract and the essentials of the transaction cost economies. The contract involves stakeholders such as the medical institutions, the health professionals/personnel, and the payers or the beneficiaries of the Medicare programs. The collaboration of the health stakeholders such as the physicians, payers, and the medical institutions will reflect the accountability of the individuals involved in lowering the cost of health services and the improvement of the care services. The understanding of the contractual details will involve the aspects of evaluating the transaction EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 7 costs associated with the ACO implementation strategy (Berkowitz & Pahira, 2014). The transaction costs are the expenses involved in gathering the required information, the negotiation, legal fees, contracting expenditure, and the monitoring expenses in the process of implementing the ACO program. The evaluation of the structure of ACO is also effective in evaluating its success and effectiveness in a healthcare organization. The structure is evaluated by the structural contingency theory which illustrates the internal arrangement of an effective ACO program. For example, the theory explains the environment that is suitable n enhancing the functionality of the ACO program. The environment of ACO will indicate the presence of the domain of care coordination, the internal relationships, the health information technology structure, and the composition of the reliable participants in the medical institution (Lloyd, Houston, & McGinnis, 2015). The care coordination aspects will involve the approaches of leadership strategies, the definition of roles and responsibilities, and the availability of a well-defined hierarchical structure and the flow of command in the management. The improvement and the evaluation of the health information technology can also be influential in the success of ACO based on the elements of improving the adoption of strategies such as Electronic Health Records due to the approach of enhancing the reporting and evaluation of vital documents in the healthcare organization. The health information technology will improve the competence of the ACO program and the success of a healthcare institution. The solidity of the internal relationships in a healthcare institution can create a platform that will enhance the implementation of the ACO program (Singer & Shortell, 2011). Internal relations portray the strength of the collaboration and communication of the health care professionals within the hospital settings and the adjustment of the strategies that could help in attaining high levels of performance. Caregivers’ involvement and participation can also enhance the aspects of creating strong internal relations. Also, task differentiation can be attained through the identification of the size of the organization as well as the definition of the care systems and the roles and responsibilities of the involved parties in the delivery of effective, efficient, and affordable healthcare services to the communities. Importance and Intended Benefits of ACO Implementation Accountable Care Organizations has managed to gather and coordinate the group of health professionals and healthcare institutions in collaborating to provide effective and efficient health care services to a community. The organizations and programs are aimed at enhancing the approaches of improving the care services at cheaper costs. The implementation of ACO programs has enhanced the strategic approaches of communication within the healthcare system. The communication is made better and easier based on the aspects of collaboration, availability of communication network, exchange of data, minimization of duplication of services, and the improvement of the overall health care service delivery (Singer & Shortell, 2011). Also, the implementation of ACO programs has created an environment that is suitable for cost advantage realization. Institutions that are working under ACO benefits from the involvement and coordination of healthcare stakeholders as well as the contributions obtained from the federal government alongside the healthcare system. The cost advantage involves the approach of receiving the bonus and the payments made from the Medicare programs. Comprehensive care is improved based on the implementation of the ACO program in healthcare institutions. Comprehensive care is considered as the approach of improving the availability of the nurses, doctors, and specialists who cater to a large number of patients in the medical facility. EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 8 The adoption of ACO can also be effective in reducing the burdens of the payment of health services to the users. The Medicare program is used in the adoption of ACO as it improvises the approaches of adjoining the payers, insurance companies, and healthcare institutions (Lloyd, Houston, & McGinnis, 2015). The approach of paying for care services is made easier and cheaper based on the involvement of strategies that are improving the delivery of care services. The implementation of ACO has shifted the focus of insurance companies in driving the care plans and allocating the responsibility to the health professionals and medical institutions. The focus has facilitated the approach of identifying the challenges and opportunities for improving the delivery of effective care services. The primary objective of ACO is to provide high-quality care services at reduced prices and the responsibility has eliminated the expenses incurred by the payers in accessing healthcare services in the country. The approach has also identified an increase in the availability of medical professionals at the expense of the Medicare and the federal government rather than the expenses of the payers and the beneficiaries (Fisher et al., 2012). Therefore, the adoption of the ACO program in the healthcare institutions will improve the delivery of care services as well as reduce the costs of healthcare expenditure to the government and the Medicare beneficiaries. The program will further demonstrate the effectiveness and improvement of healthcare professionals. Challenges of Implementing the ACO Program The evaluation of the effectiveness of the ACO program can involve the assessment of the high costs of the information technology infrastructure that is involved in implementing the program. The information technology infrastructure is considered relatively high when compared to the benefits of the program. The implementation plan should involve the issues linked to the confidentiality and discretion of organizational matters (Lloyd, Houston, & McGinnis, 2015). The implementation of ACO will portray the need for involving other stakeholders who will be part of the decision-making procedures and can affect the privacy of the health information. Also, data security can be a problem whereby the patients’ information can be accessed and manipulated by other stakeholders in the healthcare system. The changes in information technology and management structure will complicate the settings of the medical facility which will reflect the need for new ways of doing things. The use of ACO will portray the shift and increase of patients that will be catered under the Medicare programs and can complicate the strategies of improving care service delivery depending on the size of the facility and the competence of the health personnel teams (Singer & Shortell, 2011). The program does not guarantee success as some health institutions using the program has recorded losses that are incurred after the failure of attaining or reaching the expected targets. The increased expenses will affect the improvement of service care delivery. Therefore, the implementation of the ACO program will require extensive evaluation which will analyze the benefits that surpass the disadvantages of the program and the options and strategies that will be used in advocating for its success. Implementation Timeline • 1st month – data acquisition, IT infrastructure, • 2nd Month – data warehouse platform, financial incentive evaluations, satisfaction assessment • 3rd Month – foundational creation, discovery assessment, clinicians exploring data, sign contract • 4th Month – ancillary assessment, evaluation of possible challenges, adoption of the program EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 9 Evaluation Timeline • 5th Month – baseline measurement, • 6th month – first follow-up measurement • 7th – month – performance improvement strategy • 8th month – process evaluation • 9th month – second follow-up measurement • 10th month – evaluation of measurement strategies • 11th month – sealing the long-term contract Conclusion The adoption and implementation of Accountable Care Organizations in the healthcare system are aimed at improving the delivery of quality care services as well as reduce the costs of health care services. The program is considered effective as it coordinates the collaboration and formation of groups aimed at improving the quality of care services in a community. ACO program further demonstrates the prerequisites of enhancing and attaining the healthcare objectives which are to improve the quality of lives of the communities. The strategies utilized by the program involves the improvement of information technology infrastructure, the involvement of the Medicare program, the collaboration with healthcare stakeholders, policymakers, and the federal government in improving the healthcare practices. Therefore, the evaluation plan has assessed the fundamentals that would be effective in implementing the ACO in the healthcare system aimed at improving the overall delivery of effective, efficient, and affordable health care services. EVALUATION PLAN FOR ACCOUNTABLE CARE ORGANIZATIONS 10 References Berkowitz, S. A., & Pahira, J. J. (2014). Accountable care organization readiness and academic medical centers. Academic Medicine, 89(9), 1210-1215. Blackstone, E. A., & Fuhr Jr, J. P. (2016). The economics of Medicare accountable care organizations. American health & drug benefits, 9(1), 11. Fisher, E. S., Shortell, S. M., Kreindler, S. A., Van Citters, A. D., & Larson, B. K. (2012). A framework for evaluating the formation, implementation, and performance of accountable care organizations. Health affairs, 31(11), 2368-2378. Lloyd, J., Houston, R., & McGinnis, T. (2015). Medicaid accountable care organization programs: State profiles. Hamilton, NJ: Center for Health Care Strategies. Palazzolo, J. (2015). A Multi-theory Application: The Evaluation of Accountable Care Organizations. Management Avenir Sante, (1), 19-36. Singer, S., & Shortell, S. M. (2011). Implementing accountable care organizations: ten potential mistakes and how to learn from them. Jama, 306(7), 758-759. Plagiarism Checker X - Report Side by Side Difference Overall Similarity: 91% Date: May 9, 2021 Statistics: 3859 words Plagiarized / 4243 Total words Remarks: High similarity detected, you must need to improve the document. Target (B) Source (A) Health Evaluation Plan Your Name Your University Course Name and Number Evaluation Plan for Accountable Care Organizations Professor Name 9th May 2021 Name Institution Evaluation Plan for Accountable Care Organizations Introduction The healthcare system has assessed the effective strategies that would help in improving the delivery of efficient health services and the reduction of healthcare (Total Words: 4072) costs in the country. The emergence of Accountable Evaluation Plan for Accountable Care Organizations Care Organizations, health care payment methods, and Introduction delivery models has created a platform that will benefit The healthcare system has assessed the practical the healthcare system (Blackstone & Fuhr Jr., 2016). The strategies that would help improve efficient health methods are aimed at improving the work of the health services and reduce healthcare costs in the country. The professionals and the medical institutions towards the emergence of Accountable Care Organizations, health success of the healthcare system. For instance, the care payment methods, and delivery models has Accountable Care Organizations (ACOs) are considered created a platform that will benefit the healthcare as the contracts and agreements between healthcare system (Blackstone & Fuhr Jr., 2016). The strategies aim professionals and health institutions in reducing the to improve the work of the health professionals and the health care costs as well as the implementation of medical institutions towards the success of the strategies that are effective in improving the delivery of healthcare system. For instance, the Accountable Care effective, efficient, and affordable care services Organizations (ACOs) are considered as the contracts (Palazzolo, 2015). The implementation of the ACOs in a and agreements between healthcare professionals and healthcare institution will reflect the evaluation of its health institutions in reducing the health care costs as benefits to cost reduction and the improvement of the well as the implementation of strategies that are delivery of care services. The timeline will involve the effective in improving the delivery of effective, efficient, assessment of the effective program, the contractual and affordable care services (Palazzolo, 2015). agreements, and the installation of the appropriate Implementing the ACOs in a healthcare institution will programs. Therefore, the evaluation plan will reflect the evaluation of its benefits to cost reduction incorporate the project objectives, the evaluation and the improvement of the delivery of care services. methods, the measurement strategies, and the timeline The timeline will involve assessing the practical suitable for the completion of the ACOs program. program, the contractual agreements, and installing the Project Objectives appropriate programs. Therefore, the evaluation plan The implementation of Accountable Care Organizations will incorporate the project objectives, the evaluation in healthcare institutions is aimed at improving the methods, the measurement strategies, and the timeline delivery of care services and the reduction of healthcare suitable for completing the ACOs program. costs. The project aims at introducing new payment Project Objectives systems as well as to reform the healthcare system The implementation of Accountable Care Organizations through the coordination and collaboration of health in healthcare institutions aims to enhance the delivery professionals, health institutions, the federal of service care and minimize healthcare prizing. The government, and the healthcare stakeholders such as project aims to introduce new payment systems and the policymakers (Palazzolo, 2015). Therefore, the reform the healthcare system through the coordination project aims at the following objective; and collaboration of health professionals, health ? Deliver seamless healthcare services institutions, the federal government, and the healthcare ? Provide high-quality health services stakeholders such as policymakers (Palazzolo, 2015). ? Improvise the system that will benefit the Therefore, the project aims at the following objective; Medicare beneficiaries ? Deliver seamless healthcare services ? Lower the costs of healthcare services ? Provide high-quality health services ? Improve patient safety ? Improvise the system that will benefit the ? Enhance preventive care Medicare beneficiaries ? Focus on the at-risk population ? Lower the costs of healthcare services ? Care coordination ? Improve patient safety ? Involve theories that elaborate on the ? Enhance preventive care ? Focus on the at-risk population ? Care coordination ? Involve theories that elaborate on the effectiveness of ACOs ? project Provide a timeline for the completion of the Evaluation Questions effectiveness of ACOs i. ? What are the objectives and goals of Provide a timeline for the completion of the implementing the ACOs? project ii. ? Evaluation Questions ? What are the objectives and goals of What will be the benefits of implementing ACOs? iii. How will the healthcare system profit from the implementing the ACOs? adoption of ACO programs? ? iv. How will the ACO program work? ACOs? v. What will be the prerequisites of joining the ? ACOs? vi. What will be the benefits of implementing How will the healthcare system profit from the adoption of ACO programs? What are the implications of professional ? How will the ACO program work? liabilities after joining ACOs? ? What will be the prerequisites for joining the vii. ACOs? What are the ACOs' quality measurement metrics? ? What are the implications of professional viii. Will the ACO monitor patient satisfaction? liabilities after joining ACOs? ix. What will the ACO involve in measuring its ? success? x. What are the ACOs' quality measurement metrics? How will the change of implementing ACO ? Will the ACO monitor patient satisfaction? affect healthcare organizational structure? ? What will the ACO involve in measuring its Evaluation Methods success? The evaluation of the effectiveness and the implications ? of ACOs in the healthcare system are based on the affect the healthcare organizational structure? assessment of its benefits and its importance in Evaluation Methods delivering the desired and projected objectives. The The evaluation of the effectiveness and implications of evaluation plan will involve the aspects of assessing the ACOs in the healthcare system is based on assessing its data and success measurement strategies (Palazzolo, benefits and its importance in delivering the desired 2015). For instance, the data evaluation will involve the and projected objectives. The evaluation plan will elements of assessing the costs and economic involve assessing the data and success measurement importance of the implementation of ACOs in strategies (Palazzolo, 2015). For instance, the data healthcare institutions. The measurements of the evaluation will include assessing the costs and success factors will also influence the aspects of economic importance of implementing ACOs in implementing the ACOs based on the acquisition of the healthcare institutions. The measurements of the intended benefits. The benefits will be measured based success factors will also influence the aspects of on the reduced rates of Medicare expenses and the implementing the ACOs based on the acquisition of the How will the change of implementing ACO improvement of the delivery of efficient care services. intended benefits. The benefits will be measured based Data Evaluation on the reduced rates of Medicare expenses and The aim of implementing ACOs in the healthcare improved delivery of efficient care services. system is based on the attainment of the intended Data Evaluation objectives which reflect the improvement of the health Implementing ACOs in the healthcare system is based service delivery and the reduction of the costs and on the attainment of the intended objectives, which expenses in health care. The modern ACA formation is reflect the improvement of the health service delivery considered different and influential when compared and the reduction of the costs and expenses in health with the traditional care system. The modern approach care. The modern ACA formation is considered different has influenced the approaches of reducing the and influential compared with the traditional care avoidable hospital admissions and shortens the system. The contemporary approach has influenced the hospital stays based on the improvement and the strategies of reducing avoidable hospital admissions sharpening of the focus of the healthcare professionals. and shortens the hospital stays based on the For instance, the readmission rates have reduced in the improvement and the sharpening of the focus of the overall United States healthcare system by 6.3% due to healthcare professionals. For instance, the readmission the utilization of the ACO strategies (Blackstone & Fuhr rates have reduced in the overall United States Jr., 2016). Also, the rate of lengthy stays in hospitals has healthcare system by 6.3% due to the utilization of the declined by 3.9%. The traditional methods had ACO strategies (Blackstone & Fuhr Jr., 2016). Also, the recorded a reduction of 3.8% of readmissions and 2.4% rate of lengthy stays in hospitals has declined by 3.9%. in the length of stays in medical facilities which The traditional methods had recorded a reduction of indicates the drop in the rates after the emergence of 3.8% of readmissions and 2.4% in the length of stays in the ACOs. medical facilities, which indicates the drop in the rates The approaches and the data representation have after the emergence of the ACOs. identified the evidence of the effectiveness and The approaches and the data representation have efficiency of the implementation of ACOs in the identified the evidence of the effectiveness and healthcare system. The implementation of ACO has also efficiency of implementing ACOs in the healthcare been involved in the evaluation of the quality of care system. The implementation of ACO has also been services rendered to the beneficiaries. The quality involved in evaluating the quality-of-care services measures have been assessed and the benefits are rendered to the beneficiaries. The quality measures deemed to help save the costs of healthcare services by have been assessed, and the benefits are deemed to Medicare program. The Medicare program through the help save the costs of healthcare services by the implementation and adoption of ACO has managed to Medicare program. Through the implementation and save $26.6 million within five years. The healthcare adoption of ACO, the Medicare program has managed institutions that had implemented the ACO programs to keep $26.6 million within five years. The healthcare have benefited and have increased the rate of saving institutions that had implemented the ACO programs healthcare costs through Medicare from $26.6 million have benefited and have increased the rate of saving to $800 million in 7 years (Blackstone & Fuhr Jr., 2016). healthcare costs through Medicare from $26.6 million The success of the program, however, depends on the to $800 million in 7 years (Blackstone & Fuhr Jr., 2016). principles and collaboration of the health professionals However, the success of the program depends on the and the management of healthcare institutions in principles and collaboration of the health professionals reaching the targets set by the Medicare and and the management of healthcare institutions in policymakers in the adoption of ACOs. Healthcare reaching the targets set by Medicare and policymakers professionals have the mandate of coordinating and in the adoption of ACOs. Healthcare professionals have enhancing their performance to attain the targets of the mandate of coordinating and enhancing their reducing the costs of care and improving the delivery performance to minimize the price of care and enhance of care services. The implementation of the ACOs has the delivery of service care. Implementation of ACOs also identified the effects of the program in changing has also identified the program's effects in changing the behaviors of the healthcare professionals the behaviors of the healthcare professionals (Palazzolo, 2015). Healthcare personnel are guided by (Palazzolo, 2015). Healthcare personnel is guided by the program in attaining the set of standards and the program in attaining the set of standards and requirements that are aimed at improving the delivery requirements aimed at improving the delivery of care of care services. Therefore, the implementation of ACO services. Therefore, the implementation of ACO in in healthcare organizations will be effective in healthcare organizations will effectively maintain the maintaining the strategies that are aimed at improving strategies aimed at improving healthcare service healthcare service delivery and the reduction of health delivery and reducing health costs. costs. Evaluation Measures Evaluation Measures The approaches of measuring the success of the ACOs The approaches of measuring the success of the ACOs in healthcare institutions can depend on the strategies in healthcare institutions can depend on the strategies aimed at informing the institution about the elements that are aimed at informing the institution about the of supporting the reduction of healthcare costs and the elements of supporting the reduction of healthcare improvement of caser service delivery. The design of costs and the improvement of caser service delivery. measuring the effectiveness of ACOs can incorporate The strategies of measuring the effectiveness of ACOs features such as expanding access to healthcare can incorporate elements such as the expansion of the services, building effective care teams, emphasizing the access of healthcare services, building of effective care wellness of the patients, and using high-quality data in teams, emphasizing on the wellness of the patients, informing healthcare decisions. The expansion of access and the use of high-quality data in informing the to care is an effective strategy for measuring the healthcare decisions. The expansion of access to care is success of implementing ACOs (Fisher et al., 2012). For an effective strategy for measuring the success of instance, healthcare institutions aim at improving the implementing ACOs (Fisher et al., 2012). For instance, delivery of health services that traditional healthcare healthcare institutions aim at improving the delivery of practices could not achieve. Improving access to care health services which could not be achieved by can involve strategies such as the availability of health traditional healthcare practices. The procedures of services and the modification of the hours of accessing improving access to care can involve strategies such as healthcare services, such as when medical institutions the availability of health services and the modification open the facilities for 24 hours. of the hours of accessing healthcare services such as Also, the strategies can involve the elements of when medical institutions open the facilities for 24 increasing the primary care services in a medical facility. hours. Primary care can include the services such as front door Also, the strategies can involve the elements of operations, general health practices, community increasing the primary care services in a medical facility. pharmacy services, dental services, eye care services, Primary care can include the services such as front door patient education, disease prevention practices, and operations, general health practices, community daycare healthcare services (Fisher et al., 2012). The pharmacy services, dental services, eye care services, availability of primary and secondary health care patient education, disease prevention practices, health services will broaden the medical practices in an maintenance, counseling, diagnosis and treatment of institution and enhance the procedures of increasing acute illnesses, inpatient care, critical care, long-term effective and efficient health care services. The health care, home-care services, and daycare healthcare institutions using the ACO programs can also measure services (Fisher et al., 2012). The availability of primary the effectiveness of the programs based on the and secondary health care services will broaden the evaluation of the time and extra hours worked by the medical practices in an institution and enhance the health professionals. procedures of increasing the delivery of effective and Health institutions should portray the presence of efficient health care services. The health institutions prolonged working hours and the availability of using the ACO programs can also measure the overtime, whereby health professionals should modify effectiveness of the programs based on the evaluation their working schedules to accommodate the treatment of the time and extra hours worked by the health of a large population of patients in a single day (Fisher professionals. Health institutions should portray the et al., 2012). The approaches will be effective in presence of prolonged working hours and the improving the delivery of health care services to cater availability of overtime whereby health professionals to the families seeking health services from the medical should modify their working schedules to institutions. Also, the health institutions using the ACO accommodate the treatment of a large population of programs will evaluate the availability of medical the patients in a single day (Fisher et al., 2012). The professionals when needed. For instance, health approaches will be effective in improving the delivery institutions should accommodate emergency and of health care services to cater for the needs of the urgent care where the health professionals should be families seeking health services from the medical available to improve the patients' quality of life. The institutions. Also, the health institutions using the ACO program, therefore, reflects the need for hiring programs will evaluate the availability of medical emergency room physicians and part-time nursing professionals when needed. For instance, the health specialists to enhance the approach of saving the lives institutions should accommodate for emergency and of patients in critical conditions. urgent care where the health professionals should be Moreover, building care teams would effectively available to improve the quality of life of the patients. measure the effectiveness and success of ACO The program, therefore, reflects the need for hiring programs. Building a care team will involve the emergency room physicians and part-time nursing approaches of involving nursing managers, a specialists to improve the approach of saving the lives collaboration of health professionals, and work of patients in critical conditions. differentiation, improving the delivery of care services Moreover, building care teams would be effective in to large populations in the community. Building an measuring the effectiveness and success of ACO efficient health professional team will also involve programs. Building a care team will involve the increasing the medical and clinical infrastructure, approaches of involving nursing managers, a adding health personnel, and growing the medical collaboration of health professionals, and work facility equipment that is effective in improving the differentiation which will improve the delivery of care delivery of quality of care to the patients (Blackstone & services to large populations in the community. Fuhr Jr., 2016). The creation of a care team will incur Building an efficient health professional team will also costs, but the outcomes will be summative based on involve the aspects of increasing the medical and the benefits and the influence of the team towards the clinical infrastructure, adding health personnel, and organizational objectives. For instance, an effective care growing the medical facility equipment that is effective team will focus on teamwork, goal setting, setting the in improving the delivery of quality of care to the bar, improved communication strategies, encouraging patients (Blackstone & Fuhr Jr., 2016). The creation of a respect and trust, determining to share roles, assigning care team will incur costs but the outcomes will be responsibilities, and learning more through summative based on the benefits and the influence of collaboration (Fisher et al., 2012). the team towards the organizational objectives. For The involvement and creation of a care team will help a instance, an effective care team will focus on teamwork, medical institution focus on the objectives of the ACO goal setting, setting the bar, improved communication program and focus on the strategies that would reduce strategies, encourage respect and trust, determining to time-wasting and improve the delivery of quality care share of roles, assigning responsibilities, and learn services. more through collaboration (Fisher et al., 2012). The Furthermore, emphasizing wellness can also be involvement and the creation of a care team will help a considered in measuring the effectiveness and medical institution in focusing on the objectives of the efficiency of ACO programs in the healthcare system. ACO program as well as the focus on the strategies that Wellness is a measure of the success of a medical would reduce time-wasting and improving the delivery program in a healthcare institution. Wellness is also the of quality care services. strategy of understanding and increasing the Furthermore, emphasizing wellness can also be awareness of an individual's health. Healthcare considered in measuring the effectiveness and professionals have the mandate of involving patients in efficiency of ACO programs in the healthcare system. making viable decisions. Wellness can also incorporate Wellness is a measure of the success of a medical the elements of having a healthy state of mind, mental program in the healthcare institution. Wellness is also stability, physical wellness, and social well-being. Health the strategy of understanding and increasing the providers can also involve the strategies that would awareness of the health of an individual. Healthcare measure and improve the wellness of the patients in a professionals have the mandate of involving patients in medical facility and the community (Fisher et al., 2012). making viable decisions. Wellness can also incorporate Emphasizing wellness will incorporate the practices that the elements of having a healthy state of mind, mental keep track of the quality metrics to each of the patients stability, physical wellness, and social well-being. Health and evaluate the progress of recovery and the efforts providers can as well involve the strategies that would and contributions of collaboration towards the measure and improve the wellness of the patients in a improvement of the quality of health of the patent. medical facility as well as in the community (Fisher et Wellness can further be implemented by enhancing the al., 2012). Emphasizing wellness will incorporate the approaches of increasing the annual wellness visits, practices that keep track of the quality metrics to each patient satisfaction, reducing the gaps of health of the patients and evaluating the progress of recovery satisfaction, improved preventive cancer screening, as well as the efforts and contributions of collaboration weigh assessments, nutrition effectiveness, prenatal towards the improvement of the quality of health of the care initiatives, controlled high blood pressure, patent. Wellness can further be implemented by depression remission, asthma admission rates, asthma enhancing the approaches of increasing the annual medication ratio, and the preventable emergency wellness visits, patient satisfaction, reducing the gaps of successes. health satisfaction, improved preventive cancer Additionally, the use of high-quality data can effectively screening, weigh assessments, nutrition effectiveness, measure the success of the implemented ACO prenatal care initiatives, controlled high blood pressure, program. High-quality data help inform health depression remission, asthma admission rates, asthma professionals about making viable decisions to improve medication ratio, and the preventable emergency effective and quality health services. successes. For example, medical institutions that have Additionally, the use of high-quality data can be implemented the ACO programs will have benefits and effective in measuring the success of the implemented advantages compared to institutions using traditional ACO program. High-quality data is useful in informing methods (Blackstone & Fuhr Jr., 2016). The benefits will health professionals concerning the approaches to increase the approaches of improving healthcare making viable decisions that would improve the service quality and reduce healthcare costs, which will delivery of effective and quality health services. For attract customers from the community. The health example, medical institutions that have implemented institutions will shift the referral strategies, which will the ACO programs will have benefits and advantages increase the rate of medical admissions based on the when compared to institutions that are using traditional prospects of achieving customer and patient methods (Blackstone & Fuhr Jr., 2016). The benefits will satisfaction. Also, high-quality measurement increase the approaches of improving healthcare approaches will involve evaluating the domains that will service quality as well as reduce the health care costs be useful in understanding the effectiveness of the ACO which will attract the customers from the community. program (Fisher et al., 2012). For example, chronic The health institutions will shift the referral strategies condition management can involve the measurement which will increase the rate of medical admissions of the practices of controlling the high blood pressure, based on the prospects of achieving customer and follow-up of the hospitalization of patients with chronic patient satisfaction. Also, high-quality measurement conditions, analysis of the poor control of mental approaches will involve the evaluation of the domains illnesses, access to care composites, health plan that will be useful in understanding the effectiveness of surveys, presence of the ambulatory care services, the the ACO program (Fisher et al., 2012). For example, prevalence of drug abuse, primary care enrolment chronic condition management can involve the rates, childhood immunization programs, cancer measurement of the practices of controlling the high screening practices, depression screening, effectiveness blood pressure, follow-up of the hospitalization of of contraceptive use, physical health assessment, and patients with chronic conditions, analysis of the poor the accessibility of prenatal and postpartum care in the control of mental illnesses, access to care composites, facilities. health plan surveys, presence of the ambulatory care Measurement of specific medical practices can also services, the prevalence of drug abuse, primary care help evaluate the effectiveness of the ACO programs. enrolment rates, childhood immunization programs, Various approaches can be used to measure the cancer screening practices, depression screening, success of ACO in a healthcare institution. For example, effectiveness of contraceptive use, physical health the healthcare institution can assess the policies and assessment, and the accessibility of prenatal and the strategies of asthma medication ratio, which help postpartum care in the facilities. identify the effective procedures employed by the Measurement of specific medical practices can also be health professionals in mitigating the problems of useful in evaluating the effectiveness of the ACO asthmatic conditions. Breast cancer screening and programs. Various approaches can be used to measure treatment practices can further be implemented to the success of ACO in a healthcare institution. For assess the effectiveness of the ACO implementation in example, the healthcare institution can assess the a medical facility (Berkowitz & Pahira, 2014). approaches and the strategies of asthma medication Breast cancer screening is free services that are offered ratio which are useful in the identification of the to the community in evaluating the prevalence of the effective procedures employed by the health disease in society and the healthcare organization's professionals in mitigating the problems of asthmatic efforts in preventing the spread and the effects of the conditions. Breast cancer screening and treatment disease on the patients. Cervical cancer screening can practices can further be implemented to assess the also help analyze the success of the ACO program in a effectiveness of the ACO implementation in a medical medical facility. The cervical cancer screening will facility (Berkowitz & Pahira, 2014). Breast cancer incorporate the aspects of evaluating the screening screening is free services that are offered to the services of the women in the community and the community in evaluating the prevalence of the disease assessment of practices that are involved in educating in society and the efforts of the healthcare organization women in reducing the risks of obtaining the disease. in preventing the spread and the effects of the disease The rates of controlling the high blood pressure, on the patients. Cervical cancer screening can also be therapy sessions for cardiovascular diseases, ischemic useful in analyzing the success of the ACO program in a vascular assessment, and the use of persistent Beta- medical facility. The cervical cancer screening will Blocker Treatment of heart attack will be effective in incorporate the aspects of evaluating the rate of measuring the success of ACO implementation in a screening services of the women in the community and healthcare facility. The screening and cardiovascular the assessment of practices that are involved in regulation assessment will improve the approaches to educating women in reducing the risks of obtaining the enhancing the strategic practices of enhancing or disease. The rates of controlling the high blood reducing heart failures and cardiovascular diseases pressure, therapy sessions for cardiovascular diseases, (Berkowitz & Pahira, 2014). Also, behavioral health can ischemic vascular assessment, and the use of persistent be used in assessing the effectiveness of the ACO Beta-Blocker Treatment of heart attack will be effective program. For instance, the evaluation of depression and in measuring the success of the implementation of ACO mental disorder readmissions, depression clinical in a healthcare facility. The assessment of the screening follow-ups, alcohol and substance abuse treatments and cardiovascular regulation will improve the will be effective in measuring the success of the ACO approaches to enhancing the strategic practices of program and the efforts of the healthcare professionals improving or reducing heart failures and cardiovascular in improving the delivery of quality health care services diseases (Berkowitz & Pahira, 2014). Also, behavioral to the community. The availability of optimal diabetes health can be used in assessing the effectiveness of the care, comprehensive diabetes care, and statin therapy ACO program. For instance, the evaluation of for diabetes can also be used in measuring the success depression and mental disorder readmissions, of the ACO programs (Singer & Shortell, 2011). The depression clinical follow-ups, alcohol and substance success of the ACO programs in the healthcare abuse treatments will be effective in measuring the institutions will reflect the evaluation of the success success of the ACO program and the efforts of the factors such as improving the service care and the healthcare professionals in improving the delivery of decrease costs of health services. quality health care services to the community. The Theoretical Approach to Implementing ACO Programs availability of optimal diabetes care, comprehensive Accountable Care Organizations are considered diabetes care, and statin therapy for diabetes can also effective in enhancing the improvement of care services be used in measuring the success of the ACO programs and reducing the costs of healthcare services in a (Singer & Shortell, 2011). The success of the ACO community. The implementation of ACO aims to form programs in the healthcare institutions will reflect the the intended objectives and analyze the inputs and the evaluation of the success factors such as the resources used in improving the healthcare system. The improvement of the service care and the decrease costs implementation strategy can be analyzed through the of health services. evaluation of Fisher's Logic Model. The model Theoretical Approach to Implementing ACO Programs elaborates on the theory of distinguishing the aspects Accountable Care Organizations are considered of the formation, the implementation, and the effective in enhancing the improvement of care services operation of the ACO programs. Fisher further and the reduction of the costs of healthcare services in demonstrates the elements of collecting data relevant a community. The implementation of ACO is aimed at in forming the program, the elements of ACO contracts, forming the intended objectives and analyzing the and the structure of the program in enhancing and inputs and the resources used in improving the attaining the objectives of the healthcare system healthcare system. The implementation strategy can be (Berkowitz & Pahira, 2014). The program also involves analyzed through the evaluation of Fisher's Logic evaluating the environmental contexts, the readiness of Model. The model elaborates on the theory of the organization, the implementation activities, the distinguishing the aspects of the formation, the intermediate outcomes, and the impacts of the implementation, and the operation of the ACO program in improving the healthcare system and the programs. Fisher further demonstrates the elements of improvement of care service delivery. For instance, the collecting data that is relevant in forming the program, implementation of the ACO program will reflect the the elements of ACO contracts, and the structure of the need for the evaluation of the local context, which is program in enhancing and attaining the objectives of considered the resource dependency theory. The the healthcare system (Berkowitz & Pahira, 2014). The resource dependency theory involves evaluating the program also involves the approaches of evaluating the efficiency of the healthcare institution's stakeholders, environmental contexts, the readiness of the such as the suppliers, distributors, and investors, in organization, the implementation activities, the creating a platform that will improve the dependency intermediate outcomes, and the impacts of the and the success of the ACO program. The theory program in improving the healthcare system and the further demonstrates the aspects of utilizing ACO in improvement of care service delivery. For instance, the improving the associations and collaborations within implementation of the ACO program will reflect the the healthcare institutions based on the elements of need for the evaluation of the local context which is organizational behaviors, the certainty of health considered as the resource dependency theory. The professionals, forming alliances, reduce dependency, resource dependency theory involves the evaluation of and increase influence towards other health personnel the efficiency of the healthcare institution's in promoting organizational performance (Berkowitz & stakeholders such as the suppliers, distributors, and Pahira, 2014). investors in creating a platform that will improve the Also, the local context and the resource dependency dependency and the success of the ACO program. The theory elaborate on the essential elements that would theory further demonstrates the aspects of utilizing be effective in evaluating the possible impacts of ACO in improving the associations and collaborations implementing ACO in a healthcare institution. within the healthcare institutions based on the Furthermore, the implementation of the ACO program elements of organizational behaviors, the certainty of depends on the nature of the contract and the health professionals, forming alliances, reduce essentials of the transaction cost economies. The dependency, and increase influence towards other contract involves stakeholders such as the medical health personnel in promoting organizational institutions, the health professionals/personnel, and the performance (Berkowitz & Pahira, 2014). Also, the local payers or the beneficiaries of the Medicare programs. context and the resource dependency theory elaborate The partnership between the health sector and the on the essential elements that would be effective in health receivers is key to making sure that the evaluating the possible impacts of implementing ACO accomplishments of these organizations are in a healthcare institution. established. Understanding the contractual details will Furthermore, the implementation of the ACO program include evaluating the transaction costs associated with depends on the nature of the contract and the the ACO implementation strategy (Berkowitz & Pahira, essentials of the transaction cost economies. The 2014). The transaction costs are the expenses involved contract involves stakeholders such as the medical in gathering the required information, the negotiation, institutions, the health professionals/personnel, and the legal fees, contracting expenditure, and the monitoring payers or the beneficiaries of the Medicare programs. expenses in implementing the ACO program. The collaboration of the health stakeholders such as The evaluation of ACO structure is also practical in the physicians, payers, and the medical institutions will evaluating its success and effectiveness in a healthcare reflect the accountability of the individuals involved in organization. The structure is assessed by the structural lowering the cost of health services and the contingency theory, which illustrates the internal improvement of the care services. The understanding of arrangement of an effective ACO program. For the contractual details will involve the aspects of example, the theory explains the environment that is evaluating the transaction costs associated with the suitable n enhancing the functionality of the ACO ACO implementation strategy (Berkowitz & Pahira, program. The atmosphere of ACO will indicate the 2014). The transaction costs are the expenses involved presence of care coordination, the internal in gathering the required information, the negotiation, relationships, the health information technology legal fees, contracting expenditure, and the monitoring structure, and the composition of the reliable expenses in the process of implementing the ACO participants in the medical institution (Lloyd, Houston, program. & McGinnis, 2015). The care coordination aspects will The evaluation of the structure of ACO is also effective involve the approaches of leadership strategies, the in evaluating its success and effectiveness in a definition of roles and responsibilities, and the healthcare organization. The structure is evaluated by availability of a well-defined hierarchical structure and the structural contingency theory which illustrates the command flow in the management. internal arrangement of an effective ACO program. For The improvement and the evaluation of the health example, the theory explains the environment that is information technology can also be influential in the suitable n enhancing the functionality of the ACO success of ACO based on improving the adoption of program. The environment of ACO will indicate the strategies such as Electronic Health Records due to the presence of the domain of care coordination, the approach of enhancing the reporting and evaluation of internal relationships, the health information vital documents in the healthcare organization. The technology structure, and the composition of the health information technology will improve the reliable participants in the medical institution (Lloyd, competence of the ACO program and the success of a Houston, & McGinnis, 2015). The care coordination healthcare institution. The solidity of the internal aspects will involve the approaches of leadership relationships in a healthcare institution can create a strategies, the definition of roles and responsibilities, platform that will enhance the implementation of the and the availability of a well-defined hierarchical ACO program (Singer & Shortell, 2011). Internal structure and the flow of command in the relations portray the strength of the collaboration and management. The improvement and the evaluation of communication of the health care professionals within the health information technology can also be the hospital settings and the adjustment of the influential in the success of ACO based on the elements strategies that could help attain high levels of of improving the adoption of strategies such as performance. Caregivers' involvement and participation Electronic Health Records due to the approach of can also enhance creating solid internal relations. Also, enhancing the reporting and evaluation of vital who can achieve task differentiation by identifying the documents in the healthcare organization. The health size of the organization and the definition of the care information technology will improve the competence of systems, and the roles and responsibilities of the the ACO program and the success of a healthcare involved parties in the delivery of effective, efficient, institution. The solidity of the internal relationships in a and affordable healthcare services to the communities. healthcare institution can create a platform that will Importance and Intended Benefits of ACO enhance the implementation of the ACO program Implementation (Singer & Shortell, 2011). Internal relations portray the Accountable Care Organizations has managed to strength of the collaboration and communication of the gather and coordinate health professionals and health care professionals within the hospital settings healthcare institutions to collaborate to provide and the adjustment of the strategies that could help in effective and efficient health care services to a attaining high levels of performance. Caregivers' community. The organizations and programs aim to involvement and participation can also enhance the enhance the approaches of improving the care services aspects of creating strong internal relations. Also, task at cheaper costs. Implementing ACO programs has differentiation can be attained through the enhanced the strategic approaches of communication identification of the size of the organization as well as within the healthcare system. Contact is made better the definition of the care systems and the roles and and easier based on collaboration, availability of responsibilities of the involved parties in the delivery of communication network, exchange of data, effective, efficient, and affordable healthcare services to minimization of duplication of services, and improved the communities. overall health care service delivery (Singer & Shortell, Importance and Intended Benefits of ACO 2011). Also, the implementation of ACO programs has Implementation created an environment suitable for cost advantage Accountable Care Organizations has managed to realization. gather and coordinate the group of health Institutions working under ACO benefit from the professionals and healthcare institutions in involvement and coordination of healthcare collaborating to provide effective and efficient health stakeholders and the contributions obtained from the care services to a community. The organizations and federal government alongside the healthcare system. programs are aimed at enhancing the approaches of The cost advantage involves receiving the bonus and improving the care services at cheaper costs. The the payments made from the Medicare programs. implementation of ACO programs has enhanced the Comprehensive care is improved based on strategic approaches of communication within the implementing the ACO program in healthcare healthcare system. The communication is made better institutions. Extended care is considered the approach and easier based on the aspects of collaboration, of enhancing the nurses, doctors, and specialists who availability of communication network, exchange of cater to many patients in the medical facility. data, minimization of duplication of services, and the Adopting ACO can also be effective in reducing the improvement of the overall health care service delivery burdens of the payment of health services to the users. (Singer & Shortell, 2011). Also, the implementation of The Medicare program is used to adopt ACO as it ACO programs has created an environment that is improvises the approaches of adjoining the payers, suitable for cost advantage realization. Institutions that insurance companies, and healthcare institutions (Lloyd, are working under ACO benefits from the involvement Houston, & McGinnis, 2015). The practice of paying for and coordination of healthcare stakeholders as well as care services is made easier and cheaper based on the the contributions obtained from the federal involvement of strategies that improve care services government alongside the healthcare system. The cost delivery. The implementation of ACO has shifted the advantage involves the approach of receiving the focus of insurance companies in driving the care plans bonus and the payments made from the Medicare and allocating the responsibility to the health programs. Comprehensive care is improved based on professionals and medical institutions. The focus has the implementation of the ACO program in healthcare facilitated identifying the challenges and opportunities institutions. Comprehensive care is considered as the for improving the delivery of effective care services. The approach of improving the availability of the nurses, primary objective of ACO is to provide high-quality care doctors, and specialists who cater to a large number of services at reduced prices. The responsibility has patients in the medical facility. eliminated the expenses incurred by the payers in The adoption of ACO can also be effective in reducing accessing healthcare services in the country. The the burdens of the payment of health services to the approach has also identified an increase in the users. The Medicare program is used in the adoption of availability of medical professionals at the cost of ACO as it improvises the approaches of adjoining the Medicare and the federal government rather than the payers, insurance companies, and healthcare expenses of the payers and the beneficiaries (Fisher et institutions (Lloyd, Houston, & McGinnis, 2015). The al., 2012). Therefore, the adoption of the ACO program approach of paying for care services is made easier and in healthcare institutions will improve the delivery of cheaper based on the involvement of strategies that care services and reduce the costs of healthcare are improving the delivery of care services. The expenditure to the government and Medicare implementation of ACO has shifted the focus of beneficiaries. The program will further demonstrate the insurance companies in driving the care plans and effectiveness and improvement of healthcare allocating the responsibility to the health professionals professionals. and medical institutions. The focus has facilitated the Challenges of Implementing the ACO Program approach of identifying the challenges and The evaluation of the effectiveness of the ACO program opportunities for improving the delivery of effective can involve assessing the high costs of the information care services. The primary objective of ACO is to technology infrastructure engaged in implementing the provide high-quality care services at reduced prices and program. The information technology infrastructure is the responsibility has eliminated the expenses incurred considered relatively high compared to the program's by the payers in accessing healthcare services in the benefits. The implementation plan should involve the country. The approach has also identified an increase in issues linked to the confidentiality and discretion of the availability of medical professionals at the expense organizational matters (Lloyd, Houston, & McGinnis, of the Medicare and the federal government rather 2015). Implementing ACO will portray the need for than the expenses of the payers and the beneficiaries involving other stakeholders who will be part of the (Fisher et al., 2012). Therefore, the adoption of the ACO decision-making procedures and can affect the privacy program in the healthcare institutions will improve the of the health information. Also, data security can be a delivery of care services as well as reduce the costs of problem whereby the patients' information can be healthcare expenditure to the government and the accessed and manipulated by other stakeholders in the Medicare beneficiaries. The program will further healthcare system. The changes in information demonstrate the effectiveness and improvement of technology and management structure will complicate healthcare professionals. the medical facility settings, which will reflect the need Challenges of Implementing the ACO Program for new ways of doing things. The use of ACO will The evaluation of the effectiveness of the ACO program portray the shift and increase of patients catered under can involve the assessment of the high costs of the the Medicare programs. It can complicate the strategies information technology infrastructure that is involved in of improving care service delivery depending on the implementing the program. The information size of the facility and the competence of the health technology infrastructure is considered relatively high personnel teams (Singer & Shortell, 2011). The program when compared to the benefits of the program. The does not guarantee success as some health institutions implementation plan should involve the issues linked to using the program has recorded losses incurred after the confidentiality and discretion of organizational the failure to attain or reach the expected targets. The matters (Lloyd, Houston, & McGinnis, 2015). The increased expenses will affect the improvement of implementation of ACO will portray the need for service care delivery. Therefore, the implementation of involving other stakeholders who will be part of the the ACO program will require extensive evaluation, decision-making procedures and can affect the privacy which will analyze the benefits that surpass the of the health information. Also, data security can be a disadvantages of the program and the options and problem whereby the patients' information can be strategies that will use in advocating for its success. accessed and manipulated by other stakeholders in the Implementation Timeline healthcare system. The changes in information ? 1st month – data acquisition, IT infrastructure, technology and management structure will complicate ? 2nd Month – data warehouse platform, the settings of the medical facility which will reflect the financial incentive evaluations, satisfaction assessment need for new ways of doing things. The use of ACO will ? portray the shift and increase of patients that will be assessment, clinicians exploring data, sign contract catered under the Medicare programs and can ? complicate the strategies of improving care service of possible challenges, adoption of the program delivery depending on the size of the facility and the ? Evaluation Timeline competence of the health personnel teams (Singer & ? 5th Month – baseline measurement, Shortell, 2011). The program does not guarantee ? 6th month – first follow-up measurement success as some health institutions using the program ? 7th – month – performance improvement 3rd month – foundational creation, discovery 4th Month – ancillary assessment, evaluation has recorded losses that are incurred after the failure of strategy attaining or reaching the expected targets. The ? 8th month – process evaluation increased expenses will affect the improvement of ? 9th month – second follow-up measurement service care delivery. Therefore, the implementation of ? 10th month – evaluation of measurement the ACO program will require extensive evaluation strategies which will analyze the benefits that surpass the ? disadvantages of the program and the options and Conclusion strategies that will be used in advocating for its success. The acquisition of the care organization is question was Implementation Timeline to make the health sector better and convenient. This 11th month – sealing the long-term contract ? 1st month – data acquisition, IT infrastructure, was to be achieved by making sure the quality of ? 2nd Month – data warehouse platform, service given was perfect and also minimized the financial incentive evaluations, satisfaction assessment ? 3rd Month – foundational creation, discovery assessment, clinicians exploring data, sign contract ? 4th Month – ancillary assessment, evaluation prizing of the health care sector. The health organization was seen to be perfect because it connected both the community and the health care givers. ACO program further demonstrates the of possible challenges, adoption of the program prerequisites of enhancing and attaining the healthcare Evaluation Timeline objectives, which are to improve the quality of lives of ? 5th Month – baseline measurement, the communities. ? 6th month – first follow-up measurement The strategies utilized by the program involve the ? 7th – month – performance improvement improvement of information technology infrastructure, strategy the involvement of the Medicare program, the ? 8th month – process evaluation collaboration with healthcare stakeholders, ? 9th month – second follow-up measurement policymakers, and the federal government in improving ? 10th month – evaluation of measurement the healthcare practices. Therefore, the evaluation plan strategies ? 11th month – sealing the long-term contract has assessed the fundamentals that would effectively implement the ACO in the healthcare system aimed at Conclusion improving the overall delivery of effective, efficient, and The adoption and implementation of Accountable Care affordable health care services. Organizations in the healthcare system are aimed at improving the delivery of quality care services as well as reduce the costs of health care services. The program is considered effective as it coordinates the collaboration and formation of groups aimed at improving the quality of care services in a community. ACO program further demonstrates the prerequisites of enhancing and attaining the healthcare objectives which are to improve the quality of lives of the communities. The strategies utilized by the program involves the improvement of information technology infrastructure, the involvement of the Medicare program, the collaboration with healthcare stakeholders, policymakers, and the federal government in improving the healthcare practices. Therefore, the evaluation plan has assessed the fundamentals that would be effective in implementing the ACO in the healthcare system aimed at improving the overall delivery of effective, efficient, and affordable health care services.

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