Reading through our past coverage of the Medicare accountable care organization (ACO) program can produce a lot of confusion—like these two seemingly conflicting headlines: Medicare ACOs – The Enrollment & The Savings Are Increasing ACOs Shared Savings Raised Federal Costs By $384 Million Between 2013 & 2016 The first headline is related to recently released…
Last year, Intermountain Healthcare‘s McKay-Dee Hospital in Utah opened a behavioral health center in hopes of reducing the number of patients who presented at the hospital’s ED with a behavioral health crisis—and officials say the investment is paying off, Maria Castellucci writes for Modern Healthcare. In the years before the new center opened, from 2012…
As healthcare technology continues to permeate the medical industry, experts are continuing to evaluate how connected health tools can impact patient engagement and the overall patient experience. As noted in a 2013 study in the International Journal of Medicine, connected health includes a broad set of definitions. “Connected Health encompasses terms such as wireless, digital,…
UnityPoint Health’s participation in the initial rollout of CMS’ Next Generation ACO Model helped them succeed beyond their expectations in their transition to reimbursement risk. In performance year 1 (2016), UnityPoint’s 85,000-member Iowa Health ACO earned more than $10.5 million in shared savings. Like most health systems, UnityPoint still gets more revenue from fee-for-service than…
Value-based care networks are a promising opportunity for payers that want to manage costs and improve outcomes of beneficiaries. But effectively scaling collaborative, risk-based reimbursement networks for millions of beneficiaries requires a great deal of strategy and insight. The BlueCross Blue Shield Association (BCBSA) has successfully scaled its value-based care initiatives through the Blue Distinction…
A huge chunk of organizations plan to leave the Medicare Shared Savings Program if they’re forced to take on financial risk, which could slow the government’s transition to value-based care. And it remains unclear whether the Centers for Medicare & Medicaid Services (CMS), which oversees the program, will make any sought-after changes. A recent letter from the agency, obtained by…
Most accountable care organizations say they will disband if the CMS forces them to take on financial risk next year. ACOs that started in the Medicare Shared Savings Program (MSSP) Track 1 in either 2012 and 2013 are supposed to move to a risk-based model by their third contract periods which begin next year, according…
On the road to value-based care, inadequate interoperability between diverse systems is a substantial roadblock. Although organizations are slightly better at sharing information internally, they are truly struggling with how to exchange data with external providers, payers, and other partners. Without this ability, organizations may be limited in how much they can fully pursue value-based…
As our world grows more interconnected, healthcare follows suit by making it easier for Medicaid organizations to work together on behalf of their beneficiaries and their own organization. Improving Accountable Care Organizations (ACOs) and helping them work together with greater efficiency has been a common goal for CMS and other organizations. The healthcare environment is…
In accountable care organizations (ACOs), fostering overall patient health requires high-touch patient wellness coaching. For ACOs facing the surmounting pressure to spark patient health behavior change, integrating pharmacists as another part of the clinician team is essential. At Beth Israel Deaconess Care Organization (BIDCO), a physician- and hospital-owned value-based network and ACO, leaders understand that…