Insurance Solutions for Accountable Care Organizations

Accountable Care Organizations (ACO), as introduced in the PPACA legislation (aka Obamacare) in 2010, is one way that that groups of healthcare providers will partner together to provide a full continuum of care. Although there will be differing ways in which Accountable Care Organizations are adopted, the goal will be delivering quality care and improving patient outcomes for lower costs. Of course, this will create risk and liability for the stakeholders collaborating in these new models. Some of the key risks are medical professional liability, vicarious liability, denial of care issues, negligent credentialing, cyber liability (network security), regulatory issues, billing challenges, and many others.

At Oros Risk Solutions we understand the complexities of the new emerging risks associated with Accountable Care Organizations. As specialists, we can identify those risks and properly structure coverage solutions that are tailored to your specific needs. We also understand that quality improvement and cost efficiency is paramount for Accountable Care Organizations in the environment of healthcare today (especially for ACO’s taking risk). Simply put, we want to help you improve your insurance program and associated costs. However, we prefer to do so without sacrificing coverage, financial security, and performance of the insurance company in protecting you in court. Quite frankly, our goal is to work with you over time to achieve the optimal balance between quality and the cost to transfer risk over the long time horizon; because your assets and reputation are on the line.

The insurance and consulting solutions that we offer Accountable Care Organizations include the following:

It’s about expertise and service. As specialists, we use our knowledge and relationships to your advantage. We can put you in the best possible position when we bring you all your options from one source. When we negotiate quotes with all insurance companies under consideration, we receive commissions no matter which decision you make. Therefore, our work for you becomes more about the consulting and less about someone trying to sell you something. We help you gain an understanding of the differences between options that are meaningful to you. Ideally, we strive to create an environment of unbiased advice, focusing what is best for you. Going forward, we employ a world class service model built on consistently meeting or exceeding your expectations.

Our process includes learning about your current circumstances and needs, educating you on the results of our evaluation including potential solutions, and implementing a mutually agreed upon solution. We believe all clients deserve regular communication, proactive notice of cost changes, prompt return of inquiries, and general appreciation for the opportunity to serve you. When appropriate, we customize service plans to a client’s specific needs which include elements such as market studies evaluating costs, insurer comparisons, annual education sessions, claims reviews, coverage analysis, and targeted risk management and patient safety programs.