A lot has happened in health care since 2012, when final rules permitted provider-organized ACOs to be the driving force of Value-Based Care under the 2010 Affordable Care Act (ACA). As we pass the ACA’s eleventh anniversary, a dwindling number of Medicare Shared Savings Program (MSSP) ACOs are entering a new phase marked by higher…
The Medicare Payment Advisory Commission, at its meeting on Thursday, approved several Medicare policy recommendations that will appear in its June report to Congress. The congressional advisory panel will recommend that CMS simplify its approach to alternative payment models. Commissioners approved an updated version of the recommendation presented by MedPAC’s staff at last month’s meeting….
It’s been a decade since the launch of accountable care organizations, but many are still struggling to realize their original goal: providing high-quality care while lowering, or at least slowing the rise of, the nation’s health care spending. That was the message Michael Chernew, PhD, and Jay Crosson, MD, the current and immediate past presidents,…
In its June report, the Medicare Payment Advisory Commission (MedPAC) said the program needs to move more quickly away from fee-for-service (FFS) payments. “The commission has made an assertion that the progress towards value-based payment throughout the Medicare program needs to accelerate and more of the program needs to be detached from straight fee-for-service payments,” said…
The Medicare Payment Advisory Commission is recommending that the Centers for Medicare & Medicaid Services scrap pandemic-skewed 2020 performance benchmarks for at-risk accountable care organizations. “The COVID-19 public health emergency has likely affected—and will continue to affect, at least through 2020—Medicare spending in ways that are yet to be fully understood,” MedPAC Chairman Francis J….
The notion that hospitals can reduce readmissions, and that punishing them for “excess” readmissions will get them to do that, became conventional wisdom during the 2000s on the basis of very little evidence. The Medicare Payment Advisory Commission (MedPAC) urged Congress to enact the Hospital Readmissions Reduction Program (HRRP) beginning in 2007, and in 2010…
The notion that hospital readmission rates are a “quality” measure reached the status of conventional wisdom by the late 2000s. In their 2007 and 2008 reports to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress authorize a program that would punish hospitals for “excess readmissions” of Medicare fee-for-service (FFS) enrollees. In 2010, Congress…
Medicare ACOs are designed to slow growth in Medicare spending and improve the quality of care delivery. Since the first ACOs were established in 2012, there has been a persistent question of whether the population health management and wellness measures employed by ACOs will result in fewer inpatient stays and lower hospital revenue. Can ACO participation be worth the financial risk for inpatient hospitals? Ultimately, no hospitals would be willing to join an ACO if lower revenue put the…
The Medicare Shared Savings Program (MSSP), now in its sixth full performance year, is at a significant crossroads. In creating the MSSP, Congress envisioned that Medicare accountable care organizations (ACOs) could moderate Medicare spending and improve quality of care by providers taking greater responsibility for costs and quality. While MSSP ACOs have clearly improved the…
Medicare accountable care organizations (ACOs) operating under two-sided financial risk arrangements save the federal healthcare program more than one-sided risk organizations. But policymakers must address financial incentives, benchmarks, and other issues to ensure two-sided risk ACOs continue to generate savings, the Medicare Payment Advisory Commission (MedPAC) recently reported. “Medicare ACOs were created to help moderate…
