The March 2010 enactment of the Affordable Care and Reconciliation Acts (ACA) is providing incentives for the development of integrated patient-centered delivery systems designed to reward providers that improve care coordination, quality and transparency.  Primary care providers are being encouraged to achieve certification as patient centered medical homes, to provide access to all levels of care while managing the transitions between levels of care and improving communication between the team of providers, with a focus on improving safety, clinical care and system integration.

The ACA will also expand care for millions of uninsured Americans, most notably childless adults, under a landmark expansion of Medicaid.  This expansion, as well as innovative federal initiatives, has significant implications for safety net providers, including public and private hospitals, health systems, Federally Qualified Health Centers (FQHCs), physicians and health departments.  Such initiatives include Accountable Care Organizations (ACOs) and new payment models, such as bundled payments, value based purchasing and integration of Medicare and Medicaid payments for dually eligible individuals. The common goal is a focus on delivery system accountability for high-quality, cost-effective care.

SGA closely monitors this changing health care environment and can provide in-depth analysis of the key legislative issues affecting safety net providers and its potential impact on you.  Firm activities include:

• Monitoring and summarizing CMMI and CMS initiatives
• FQHC Feasibility Analysis & FQHC Application
• Strengthening Partnerships in alignment with CMMI’s initiatives
• Understanding State of IL Care Coordination Initiative
• Preparation for certification as a Patient Centered Medical Home (PCMH)
• Strategies to participate in Accountable Care Organizations (ACOs)
• Expertise on dual eligible individuals (Medicaid/Medicare)
• Improved management of capitation and other reimbursement models
• Developing and Conducting Needs Assessments
• Building Collaborative Relationships
• Strategic Planning for Health Systems, Community Health Centers, Physicians
• Complex Project Management for public agencies and health systems
• Operational Assessments for long term Sustainability and Capacity Expansion
• Strategic Positioning & Business Plan Development
• Community Needs Assessment & Target Population Strategies