Accountable care organizations are claiming they don’t have all the information needed to decide if they want to participate in the direct-contracting options from the Center for Medicare and Medicaid Innovation even though the deadline to apply for the implementation period is days away. The application window to participate in the implementation period of the direct-contracting models…
Patients receiving primary care outside of their defined accountable care organization (ACO) network drive up costs for ACOs, a recent study from Portland State University said. The Medicare Shared Savings program sparked the growth of ACOs. These payment models intend to reduce healthcare costs while improving patient care through care coordination among a network of participating providers. Those…
Accountable Care Organizations formed for the first time in 2011 and were designed to combat rising medical costs and provide more coordinated care to Medicare patients. But the savings have been inconsistent nationwide. A new Portland State University study looked at what’s driving these inconsistencies and what ACOs might do to resolve the issue. The study…
Want doctors to get into alternative payment model arrangements like accountable care organizations (ACOs)? Start with “baby steps” like giving them only upside risk, Greg Griggs, executive vice president and CEO of the North Carolina Academy of Family Physicians, in Raleigh, said here at the National Health Policy Conference. “I think there is becoming more…
The passage of the Affordable Care Act sparked many innovative care delivery and payment reform models. One unique model that emerged from this trend was the accountable care organization (ACO). In this model, groups of doctors, hospitals, and other health care providers voluntarily come together to deliver coordinated, high-quality care to patients. The organizations achieve…
Small physician-led Accountable Care Organizations (ACOs) have shown success in reducing costs while improving quality. But they need more support to continue down that road, according to a new report. Those ACOs would benefit from more guidance and support from the Centers for Medicare & Medicaid Services (CMS), private insurers and other sources as they…
Despite interest in addressing social determinants of health (SDOH) to improve patient outcomes, little progress has been made in integrating social services with medical care. Even for accountable care organizations (ACOs) that have been early adopters in addressing social needs, significant difficulties have been experienced in this area. These findings were detailed in the February issue of Health…
Accountable Care Organizations who are at risk of owing money back to Medicare because they haven’t met spending targets on shared-risk beneficiaries now have more freedom to use telehealth. Under a guidance document released last month by the Centers for Medicare & Medicaid Services, ACOs participating in a Medicare Shared Savings Program that is under…
Accountable care organizations have major challenges integrating social services with medical care, including a lack of data on their patients’ social needs and the capabilities of community partners. That’s the finding of a new study published in the journal Health Affairs, based on qualitative data from 22 ACOs. “The ACOs in our sample frequently lacked data about several…
The Next Generation Accountability Care Organization Program appears to be on shaky ground as the Trump administration questions its capacity to generate savings and a potential replacement revs up. The five-year demonstration program will expire at the end of 2020 unless the Department of Health and Human Services Secretary Alex Azar decides to extend it or make…
Despite agreement that the social determinants of health (SDOH) can impact accountable care organization (ACO) success, many see challenges in integrating interventions into practice, according to a new study published in Health Affairs obtained ahead of print by journalists. Specifically, ACOs face challenges in collecting data about patients experiencing key SDOH, creating meaningful community health partnerships, and…
AMGA (American Medical Group Association) recently sent a letter to Congress outlining what it views as 2020’s top priorities for medical groups and health systems. Chief among the group’s recommendations was better claims data access for providers and patients in a value-based care world. Congress and the administration have made it clear that how healthcare is financed…
