Physician-led ACOs saved Medicare $256.4 million in 2015, but hospital-led ACOs actually cost the program money that same year, according to a study published in The New England Journal of Medicine. The study, led by researchers from the Department of Health Care Policy at Boston-based Harvard Medical School, analyzed Medicare claims from 2009 through 2015….
Employing additional administrative staff, prioritizing care management, and building data analytics capacity were key strategies accountable care organizations (ACOs) implemented to participate in the Next Generation model, CMS recently reported. The initial group of ACOs generated net savings of $62 million to Medicare while maintaining care quality, CMS reported in an evaluation of the model’s…
As healthcare organizations develop more sophisticated big data analytics capabilities, they are beginning to move from basic descriptive analytics towards the realm of predictive insights. Predictive analytics may only be the second of three steps along the journey to analytics maturity, but it actually represents a huge leap forward for many organizations. Instead of simply…
ACOs continued to grow in size and count in 2017 and early 2018, according to an analysis from Leavitt Partners and the Accountable Care Learning Collaborative. Here are four findings from their report, published in Health Affairs. 1. There were 1,477 ACO contracts at the end of the first quarter of 2018, spread among 1,011…
The CMS made a profit from the Medicare Shared Savings Program last year as more accountable care organizations moved to risk-based contracts and gained experience, new federal data show. About 60% of the 472 Medicare ACOs generated a total of $1.1 billion in savings in 2017, according to the CMS data set released Thursday. The…
Although Next Generation ACOs have performed well in their first year, health IT challenges like interoperability may be standing in their way of achieving greater success, according to a CMS evaluation prepared by NORC at the University of Chicago. CMS launched the Next Generation ACO models in 2016 under the vision that providing strong financial…
Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) generated about $314 million in net Medicare savings in 2017, according to new MSSP performance data from CMS. In 2017, 472 ACOs in the largest Medicare ACO program treated approximately 9 million Medicare beneficiaries, the National Association of ACOs (NAACOS) reported in a new…
The challenges of lowering care costs and improving healthcare quality may lead payers to consider the use of capitated payments as part of their value-based payment model strategies. Capitated payments are pre-arranged payments for healthcare providers to deliver services on a per member per month (PMPM) basis. Providers are paid a set amount for each…
Whatever may come, CMS Administrator Seema Verma is standing steadfast in her “tough-love” stances towards providers when it comes to ACO development. As Healthcare Informatics Associate Editor Heather Landi wrote on Monday, “During a webinar sponsored by the Accountable Care Learning Collaborative Monday morning, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma reiterated…
Evidence-based medicine goes beyond choosing the right clinical pathway, prescribing the right medication, or following procedural standards. Evidence-based decision-making also extends to targeting the right patients at the right time, employing preventive programs, and using diverse clinical teams to serve patient populations. Reviewing Medicare claims data is a valuable first step for accountable care organizations…