The Medicare Shared Savings Program added about 40 new ACOs, effective July 1, according to the National Association of ACOs. The new entrants mark a decline from the program’s first seven years, when the program averaged more than 100 new ACOs each year. In total, the MSSP program lost 43 ACOs this year, with a total…
Download Slides What will be covered in this presentation: Current state of value-based payment models Similarities and differences across Medicare Advantage and Medicare patient populations, attribution methods, payment mechanisms, quality metrics, post-acute care pathways, and other concepts for contract negotiation Required resources and infrastructure for maintenance and management. Visit Salient Healthcare Booth
Dr. W. Edwards Deming first coined the oft-repeated phrase, “Every system is perfectly designed to get the results it gets.” This has become a fundamental truth, so it should surprise no one that when the government designs programs that reward the wrong behaviors and encourage higher costs without improvements in quality, that is exactly what…
The Accountable Care Organization (ACO) Investment Model (AIM) saved the Centers for Medicare & Medicaid Services (CMS) more than $48M in its first year while promoting improved health care in rural and underserved areas, according to a new study from Abt Associates. The new study reveals that after accounting for the $82.4 million provided to ACOs, AIM reduced CMS expenditures…
An ACO’s ability to reduce spending requires more than primary care providers’ efforts. It also seems to require a specific balance of involvement from medical specialists, finds a new study in JAMA Network Open. UMass Amherst researchers examined data on 620 ACOs from CMS’ Shared Savings Program to investigate the association between office visits to medical specialists and…
Conventional wisdom holds that urban academic medical centers are ill-suited for value-based care initiatives such as the Medicare Shared Savings Program (MSSP). Nevertheless, NewYork Quality Care, the MSSP Accountable Care Organization (ACO) established in 2015 as a joint venture between NewYork-Presbyterian, Columbia University Vagelos College of Physicians and Surgeons, and Weill Cornell Medicine, achieved savings…
According to a recent Harvard report, physician burnout is “a public health crisis that urgently demands action.” Half of all doctors report troubling symptoms: depression, exhaustion, dissatisfaction and a sense of failure. These physicians are twice as likely to commit a serious medical error, research finds. Experts predict that if left unaddressed, burnout will further erode the mental health of…
The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on…
Dive Brief: Accountable care organizations that take on financial risk are more likely to be bigger, horizontally and vertically integrated, to have been exposed to other types of payment reform and have more ACO contracts across variable payer types, a new study finds. The report in Health Affairs’ July issue also found the proportion of ACOs taking on…
A new survey found that only 33% of accountable care organizations have at least one contract that takes on greater risk, and the results come as the Trump administration implements a revamp to the program. The number of ACOs taking on downside risk, where the organizations pay back the government for any losses from not meeting…
Data plays a huge role in conducting the business of healthcare, and data surrounding social determinants of health is increasingly important. With reimbursement tied to outcomes, providers need to ensure that patients are receiving the best possible care, and certain social factors can make that a challenge, from lack of housing to inadequate transportation. The challenge now…
Direct provider contracting (DPC) is coming to Medicare. Under a new announcement about reforming health care payment and delivery, the Centers for Medicare and Medicaid Services (CMS) has announced forthcoming DPC models as part of the effort to “deliver value-based transformation in primary care.” In particular, the agency seeks to implement models that enable it…
