Reducing readmissions is every hospital’s goal, but “There is a component of readmissions that has very little to do with hospital care,” said Amy Deutschendorf, MS, RN, vice president for care coordination and clinical resource management for the Johns Hopkins Health System. She groups the common causes of readmissions into five categories: 1) poor care…
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…
In a letter addressed to doctors, CMS Administrator Seema Verma reaffirmed the federal agency’s commitment to “turning the tide” of rising rates of physician burnout and reducing clinical documentation requirements to cut provider burden. “From reporting on measures that demand that you follow complicated and redundant processes, to documenting lines of text that add no…
While we served in different administrations, we faced similar challenges in trying to improve the nation’s health-care system. The basic goal was to improve the quality of the care delivered and moderate the costs. While there are several key reforms that will help us address this challenge, one idea that nearly all health leaders in…
ABSTRACT: Objectives: Accountable care organizations (ACOs) are groups of healthcare providers responsible for quality of care and spending for a defined patient population. The elimination of low-value medical services will improve quality and reduce costs and, therefore, ACOs should actively work to reduce the use of low-value services. We set out to identify ACO characteristics…
In a previous post, we examined how accountable care organizations (ACOs) would be impacted by a policy requiring a move to two-sided risk after the expiration of their current three-year term, along with the arguments for allowing ACOs to remain in one-sided risk in the Medicare Shared Savings Program (MSSP). In this, the second in…
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…
Value-based care is touted as a way of incentivizing providers to achieve the triple aim: delivering high quality care, improving population health management, and lowering healthcare costs. While shifting from a fee-for-service model to a value-based care system has the potential to improve patient health outcomes and save healthcare organizations money, the transition from the…
An avalanche of new pay proposals from the CMS seeks to reduce provider burden, so much so that it could undermine efforts to shift Medicare to a value-based system, doctors warned. The agency released a 1,400-page proposed rule July 12 that for the first time combined the annual physician fee schedule and the Medicare Quality…
When insurance plans charge patients less for the medicines that help them most, patients are more likely to take them, according to a new article. Taking a medicine every day in the hopes that it will prevent some long-range potential health catastrophe—like a heart attack or kidney failure—isn’t easy. Many people skip doses, or don’t…