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…
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…
Physicians want more than competitive compensation to work at a rural hospital. They are also looking for the autonomy and the right cultural fit, according to a new survey conducted by Jackson Physician Search. The physician recruitment firm surveyed 105 rural health system administrators and 150 physicians, of which 78 percent currently practice in a community of…
Accountable care organizations (ACOs) that provided between 40 and 45 percent of office visits through specialists had significantly lower costs compared to ACOs with the lowest and highest specialty care proportions, according to a recent University of Massachusetts Amherst study. Published in JAMA Open Network, the study of 620 ACOs in the Medicare Shared Savings Program…
Humans have been interested in artificial intelligence for as long as you or I can remember. If you’re a science fiction fan you’ll have seen it in both good (i.e. Star Trek’s Lt. Commander Data and Star Wars’ C3P0) and bad forms (i.e. The Terminator or Hal 9000 from 2001 – A Space Odyssey) since the 1980s. Suffice to say, we’re still…
The CMS Proposed Rule for the 2020 Physician Fee Schedule and changes to the Quality Payment Program picks up where the “Pathways to Success” ACO rule left off. This time, the “Pathways” shake-up is aimed squarely at MIPS, in the form of “MIPS Value Pathways.” We’ve described the growing frustration with MIPS, specifically MedPAC’s report to Congress on…
Accountable care organizations (ACOs) are increasingly realizing that they must establish post-acute care networks of preferred providers in order to control costs and maintain quality of care for their post-discharge patients. When it comes to optimizing networks of post-acute care providers—which include skilled nursing facilities (SNFs), long-term acute care hospitals, inpatient rehabilitation facilities, home health…
A federal review of 20 top-performing Medicare Shared Savings Program accountable care organizations (ACO) identified seven broad strategies for success. The Health and Human Services Office of Inspector General, relying on interviews and self-reporting from ACO officials, asked them to identify successful strategies they used to lower Medicare spending and improve care quality. The report comes…
