South Florida accountable care organization (ACO) enrollment declined 24% between 2018 and 2021 year-end according to Centers for Medicare & Medicaid Services (CMS) data. Over the same period: Miami-Dade County showed the largest decline (40%) from 29,123 enrollees to 17,378. Broward County enrollment dropped (21%) from 42,032 to 33,008. Plam Beach county enrollment declined (21%)…
Abstract Goals: Of 513 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in 2020, 67% generated a positive shared savings of approximately $2.3 billion. This research aimed to examine their financial performance trends and drivers over time. Methods: The unit of analysis was the ACO in each year of the study…
Abstract Accountable care organizations (ACOs) are becoming increasingly popular in healthcare in order to improve quality, reduce costs, and enhance patient outcomes. ACOs are an association of hospitals, healthcare providers and insurers who assume financial and medical responsibility for a patient population. In Saudi Arabia, the Ministry of Health (MOH) has been tasked with delivering…
UMass Amherst researcher Sarah Goff, MD, received a five-year, $2.2 million grant from the National Institutes of Health to examine the effects of Medicaid accountable care organizations on the quality of behavioral and mental health for Massachusetts children. Full Article
Objective To examine the effect of urologist participation in value-based payment models on the initial management of men with newly diagnosed prostate cancer. Methods Medicare beneficiaries with prostate cancer diagnosed between 2017 and 2019, with 1 year of follow-up, were assigned to their primary urologist, each of whom was then aligned to a value-based payment model…
The path to exceptional healthcare quality is understanding patients’ experiences and needs and the subsequent integration of these insights into clinical practice [1]. The importance of the patient voice is also reflected in the 2023 World Patient Safety Day theme: ‘Engaging patients for patient safety’. One way to understand patient experiences and needs is by…
The payment integrity (PI) industry plays a critical role in US healthcare, ensuring that claims adjudication is accurate and that physicians and health systems are reimbursed correctly for care delivery. We estimate the $9 billion industry has grown at a 7 percent CAGR in recent years, reflecting growth in US healthcare spending and persistent complexity…
As we described in Part 1 of this article, specialty care providers have had limited opportunities to date for engagement in accountable care models, such as accountable care organizations (ACOs), despite their critical contributions to patient care. This is a missed opportunity for payment reform, given the growing breadth and reach of ACOs and the…
What You Should Know: – Medical Home Network (MHN), a leading care enablement partner for FQHCs, announced that its partners participating in the NeueHealth Premier ACO achieved $10.1 million in gross savings and a perfect 100% quality score in the 2022 performance year. – This accomplishment, under the ACO Realizing Equity, Access, and Community Health…
Guidehealth, a value-based care enablement startup, bought Arcadia’s managed service organization and value-based care service division to build out its tools and service for providers. Guidehealth also is partnering with Arcadia, a healthcare technology company that provides a data platform to providers and payers, to use the company’s data analytics platform to power its newly acquired offering….