The Medicare Shared Savings Program, which governs the majority of Medicare accountable care organizations (ACOs), and Medicare Advantage are gaining in popularity. But the former is saving taxpayers, while the latter is incurring costs, a new report in Health Affairs finds. “Our examination of the literature indicates that Medicare Advantage ‘costs’ Medicare; that is, when a beneficiary joins MA,…
More employers increasingly will drop relationships with payers and instead contract directly with providers through accountable care organizations. Employers will want to work with ACOs with the intent of focusing on the population health of their employees, according to a new study by Frost & Sullivan, a consulting and research firm. The study, entitled Global…
The individual entities in any Accountable Care Organization (ACO) are always under the pressure to reduce their costs as well as strengthen their healthcare strategies to improve patient outcomes and maximize the benefits of being a part of the ACO. Thus, they are familiar with the fact that they need to develop strategies for accomplishing…
Last week CMS released a proposed rule addressing revisions in the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), along with a few other matters. Of 1,704 pages, only about 20 addressed ACOs issues directly. But ACOs should take a holistic approach to reading this proposed rule, as well as the proposed Outpatient Prospective Payment…
Researchers recently sought to better understand how Accountable Care Organization (ACO) participation impacts spending in rural and underserved areas. According to the study results, which are published online in the New England Journal of Medicine, Medicare spending was lower among providers serving in rural and underserved areas who also participated in ACO shared savings contracts. “The Centers…
The medical assistant-only model for primary care staffing may be the most cost-effective for practices relying on fee-for-service revenue, but the model will not be able to support value-based care and other sophisticated revenue arrangements, Premier recently reported. In a new analysis of 2018 data from 257 family medicine and primary care practices, the healthcare improvement…
Operating with one foot in fee-for-service and the other in value-based care has created significant administrative burdens for providers, so medical groups are now offering CMS value-based care reforms to simplify the model and move more providers away from volume. In response to a request for information on how to reduce administrative burdens, AMGA (American…
Healthcare organizations are continuously under pressure to evolve to meet patient needs while maintaining standards of care and keeping costs contained. Getting people on board with organizational change or innovation is hard, especially in health care.1 Staff are less likely to adopt new behaviors and practices if they perceive change or innovation clashing with longstanding…
What makes an accountable care organization (ACO) successful? Researchers with the U.S Department of Health and Human Services conducted interviews with officials from the 20 top-performing ACO’s in the Medicare Shared Savings Program. The HHS officials asked the ACO leadership to identify the strategies they used to both improve care quality and cut costs. The…
When it comes to US health care, the adage of “you get what you pay for” does not apply. The US spends more on health care than any other country, but we have lower-quality care and worse outcomes than many nations that spend considerably less. This disconnect stems from how we spend our money. Research confirms that…
