Can you help me set up this case in Healthcare Finance?

Background:

You are the Revenue Cycle Director for Great Southern Hospital (GSH) and the Chief Executive Officer has approached you about payment concerns she has about the way the hospital and its employed physicians get paid by the Medicare Program. She has shared with you her basic understanding of the Medicare Program in that hospitals are paid under Part A and physicians are paid under Part B. She also understands that Medicare has established a Part C that pays for services provided by a Medicare Advantage Plan that agrees to enter into risk-bearing contracts when they agree to coordinate the care of their Medicare patients. Part C covers services allowed under Parts A and B, but also requires a higher level of coordination of services. GSH is not able to form a Medicare Advantage Plan but may be able to form an Accountable Care Organization (ACO) because it employs many of the physicians on the medical staff. ACOs are paid under Part A and B but are loosely organized and, therefore, unable to enter into risk-bearing contracts. ACOs are allowed under the Affordable Care Act and she has asked you to provide additional information so that the management team can assess the potential of forming an ACO. The request is to bring back some high-level information about Part A, Part B, and an ACO.

Case 1: You decide that a good first step in the assessment process is to summarize several characteristics of each of the programs. You are also aware that the Medicare Payment Advisory Commission maintains a website that provides a summary of the various payment programs. For your initial report, you decide to summarize Services, Quality, and Payment Update information in preparation for the next management team meeting and that this will be a good starting point for any further discussions. Do not attempt to summarize how payments are determined. This information is available at Medpac.gov; then Documents; then Payment Basics; then select Hospital Acute Inpatient Payment System or Physician and Other Health Professional Payment System or Accountable Care Organization Payment Systems.

Provide a brief summary of Services, Quality Incentives/Penalties/Payments, as well as, Payment Updates for Part A and Part B. Compare this information to the requirements for an ACO and take particular care to compare how Medicare chooses to compensate or penalize providers for the quality of care. You have also decided that the best way to communicate this effectively to the management team is to prepare a side by side by side comparison of the characteristics of each model. Given your desire to be an excellent performer for your organization, you also decided to prepare an Executive Summary of your key findings. The purpose of your Executive Summary is to allow the management team to focus on key points for further discussion of forming an ACO. A recent news release contains some additional forward-looking information on traditional and ACO programs. Go to the Medpac.gov homepage for a News Release on Medpacs June 2020 Report to Congress. This may be helpful in framing your Executive Summary.

Helpful Hints:

Inpatient Focus on introduction, defining what Medicare buys, setting the payment rates (first paragraph only), quality incentives/payments/penalties, and payment updates.

Professional Focus on introduction, defining what Medicare buys, setting payment rates (first two paragraphs only, quality payment programs, and updating payments.

ACOs Ignore tables 1 and 2, and the risk adjustment paragraph.