In response to rising healthcare costs, providers have been pushed to take on responsibility for the health of their patients and be rewarded for outcomes rather than volume through the creation of accountable care organizations (ACOs). As Medicare forces ACOs to speed up this transition, researchers writing in the October issue of The American Journal of…
What can be done to encourage doctors and other clinicians to heed new evidence when it shows the tests or procedures they are delivering are in fact not helping their patients—and may even harm them? This question has become increasingly relevant in the face of a growing number of studies casting doubt on the safety…
Keeping within expenditure limits is a top priority for most ACOs for Medicare. That makes sense. Savings are the main distinguishing feature of an ACO arrangement, as opposed to straight Fee-for-Service reimbursement. ACOs that accept downside risk can’t afford to exceed the expenditure target. It’s in their best interest to create initiatives to cut costs…
It may come to a surprise for some that ‘healthcare innovation‘ has been in play for quite some time albeit not fueled by a culture of hacking or disrupting legacy operations principally via technology. Unfortunately a veritable acronym soup of mostly failed initiatives under varying degrees of public, private partnership (PPP) collaborations have been largely…
Proposed changes to the federal accountable care organization (ACO) model—namely, a cut in the shared savings rate from 50% to 25%—would cut the knees out from under the program, board members of the National Association of ACOs said on Thursday. Speaking with reporters at their annual conference in Washington, D.C., ACO leaders said they supported…
Accountable care organizations (ACOs) often care for many patients with complex, chronic conditions that can lead to high expenditures and utilization of care. In the United States, 1% of the population accounts for 21% of healthcare expenditures and the costliest 5% account for more than half of all health spending, according to a report published…
Although still a subject of debate, the fee-for-service health care payment system that reimburses providers for individual services is widely indicted for promoting care that is inefficient, uncoordinated, and too often fails to meet the needs of patients. Whether or not fee-for-service is the main culprit, the escalating cost and inconsistent quality of US health…
Methodist Le Bonheur Healthcare formed clinical consensus groups to create a uniform process for treating stroke and sepsis, ultimately netting the not-for-profit health system $800,000 in cost savings and revenue in the second quarter of 2018. Physicians, nurses and administrative decision-makers huddled in March 2017 to develop standards of care, weeding out any unnecessary steps…
As ACOs develop approaches to Value-Based Health Care, they are struggling with a key issue: lack of trust. How can providers commit to collective cost reductions that could have potentially negative revenue consequences for themselves individually or on their practices? If they don’t believe that the other players or their ACO are operating in the…
Physician-group accountable care organizations (ACOs) are not only more likely than hospital-integrated ACOs to be associated with savings in the Medicare Shared Savings Program (MSSP), but their savings grew over 3 years, according to research published in The New England Journal of Medicine (NEJM). Past research has shown that physician-led ACOs are more successful. The…