Track 3 and NextGen ACO’s have to demonstrate that they would be able to repay shared losses incurred at any time within the agreement period, and for a sufficient period of time following the end of each agreement period (the “tail period”), to permit CMS to calculate the amount of any shared losses that may…
Controlled studies have shown that some care management interventions, which typically support patients with outreach and regular contact by trained individuals such as nurse case managers or health coaches, can have a positive impact on health quality measures like HbA1c for diabetes. However, the impact of care management on associated costs of care is mixed…
Value-based care models are the future of pharmaceuticals but several obstacles exist slowing the transition from volume selling to value selling. More and more, companies in this space are realizing that a traditional “pharma-first” approach is no longer enough to be successful in the future. Instead, they must evolve to adopt a more patient-centric approach designed…
Accountable care organizations can bolster efforts to drive value by seeking out partnerships with providers across the continuum of care, according to a new study that aims to establish a framework ACOs can use when evaluating potential partners. Researchers with Leavitt Partners conducted a review of existing literature and convened a panel of experts to determine three elements ACOs should…
Seven accountable care organizations have left Next Generation, Medicare’s highest-risk program that qualifies as an advanced alternative payment model under MACRA. In January, the Centers for Medicare and Medicaid Services announced 58 ACOs had joined Next Gen for 2018, an increase from the estimated 28 that took part during the first year in 2016 and…
Despite recent buzz about blockchain’s potential to improve healthcare, a recent survey by SERMO found almost half of physicians aren’t aware of the technology. Industry and government stakeholders have supported efforts to use blockchain, a permanent and shared ledger of online transactions or exchanges, to streamline healthcare operations. Unlike a traditional database that is centrally…
Accountable care represents an attempt to transform how health care is delivered and reimbursed. Its core premise is to assign responsibility for a population of patients to health care providers, with payments depending on the cost and quality outcomes for that population. These providers form accountable care organizations (ACOs) to collaborate with the intent to…
Medicare Shared Savings Program (“MSSP”) Track 1+, Track 2 and Track 3 ACOs, and NextGen ACOs, have two-sided risk. CMS requires these ACOs to provide a repayment mechanism to assure that shared losses can be repaid. Depending on its track, an ACO’s repayment mechanism equals 1% or 2% of the ACO’s total per capita Medicare…
The departure of seven accountable care organizations from CMS’ Next Generation ACO Model program will likely not threaten the viability of the program, but the reasons behind the early exit are costing providers millions. The Accountable Care Coalition of Chesapeake, Allina Health, Fairview Health Services, KentuckyOne Health, Lifeprint ACO, MemorialCare and Sharp HealthCare have left…
The American Academy of Nursing is calling on nurses to better support patient education and patient health literacy as a part of the organization’s annual policy brief. “Health literacy is a precursor to health and achievement of a culture of health,” the group wrote in the brief. “Patient empowerment, engagement, activation, and maximized health outcomes…