CMS just announced the 2019 ACO application deadlines for new and renewing ACOs. The dates are extremely aggressive: Notice of Intent to Apply (NOIA) is due on Friday, January 18th at 12:00 p.m. EST Applications are due on or before February 19, 2019 For 2019, CMS is only offering a July 1, 2019 off cycle…
Until recently, efforts to improve the health of Americans have focused on expanding access to quality medical care. Yet there is a growing recognition that medical care alone cannot address what actually makes us sick. Increasing health care costs and worsening life expectancy are the results of a frayed social safety net, economic and housing…
Over two-thirds of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) would qualify as high-revenue organizations under the new Pathways to Success initiative, a recent Leavitt Partners analysis uncovered. Pathways to Success will overhaul and replace the MSSP in July 2019. “As ACOs consider entering the MSSP under the new Pathways rule, they must recognize the…
Medicare Advantage insurers added 1.4 million members to their rosters for 2019 coverage, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But Advantage membership is growing at slower pace compared with previous years. According to the latest federal data showing enrollment as of this month, 22.4…
Accountable care organizations seeking to participate in the overhauled Medicare Shared Savings Program should expect a shorter period of time to begin to reap savings through their efforts to better manage their patient populations before the Centers for Medicare & Medicaid Services expects them to shoulder more risk. So they’d better plan accordingly, according to…
If you want to understand the shifting sands of healthcare, you’ll find no better place than the nonprofit provider track during the infamous JP Morgan Healthcare Conference that took place this week in San Francisco. Over 40,000 players were in town from every corner of the healthcare ecosystem. However, if you want to hear the…
What might be in the works over at the Centers for Medicare and Medicaid Innovation (CMMI)? Are there new pilot models actively in development that will be rolled out this year? Many industry stakeholders, including federal lawmakers, are eager to know what the relatively opaque agency has in store. Created under the Obama administration, CMMI…
CMS closed 2018 with a farewell to upside-only ACOs. Perhaps the biggest surprise in the “Pathways to Success” Final ACO Rule is its consistency with the Proposed Rule, which floated the revamped ACO Track back in August. Citing superior performance among two-sided participants, as well as the belief that upside-only tracks reduce patient choice and increase costs,…
We are quickly heading to the value-based purchasing tipping point, according to the Vice President of Network Management at Health Partners Plans in Pennsylvania. “While adoption rates are still relatively low in some regions of the country, almost all health plans and providers are doing work in this space and the percentage of spending in…
Medicare accountable care organizations accepting downside financial risk will have easier access to CMS waivers of the rule requiring three-day inpatient stays before patients can be sent to skilled nursing facilities. In a guidance published Monday, the CMS laid out requirements for Shared Savings Program ACOs that apply for a waiver of the three-day stay rule. Only…
With the publication of the Medicare Shared Savings Program (MSSP) Final Rule on December 21, the Centers for Medicare & Medicaid Services (CMS) clearly signaled that the Trump administration is serious about holding accountable care organizations (ACOs) in Medicare more financially accountable for costs and quality. However, Medicare ACOs may not be the only ACOs affected by this change….
Download Pathways to Success Planning Matrix Download Slide Deck Covered in this 60 minute webinar: NOIA & Application Timeline Pathways to Success – overview Alex Azar & Seema Verma on risk ACO Alternatives How to achieve Shared Savings and more….
