The National Association of ACOs, the American Medical Association (AMA) and others have jointly signed a letter requesting that CMS (the Centers for Medicare & Medicaid Services) allow certain ACOs to continue in the Medicare Shared Savings Program (MSSP) Track 1 for a third agreement period before having to move to a two-sided risk model….
Shared decision-making is a key patient engagement strategy, but not yet widespread. Healthcare professionals say integrating the practice into value-based care could spark adoption Shared decision-making, or the practice of an informed patient participating in treatment decisions alongside her clinicians, may seem like a natural patient engagement strategy. After all, shared decision-making integrates the patient…
Hospitals that don’t adapt could get squeezed out of the care continuum as insurers grow and direct more care to lower-cost settings, according to an analysis from Moody’s Investors Service. Both not-for-profit and for-profit hospitals are feeling the pressure of falling inpatient volumes and reimbursement levels from government payers along with rising drug costs and…
Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) have shifted their spending to physician services and away from inpatient and skilled nursing facility care, according to a recent study in the American Journal of Accountable Care. The analysis of within-ACO changes between the program’s first performance year in 2013 and the most recent complete…
The Congressional budget deal passed earlier this month includes changes to the Medicare Shared Savings Program (MSSP), impacting ACOs participating in the initiative. One of the most prominent changes to the MSSP is the establishment of the ACO Beneficiary Incentive Program, which allows ACOs to pay patients up to $20 for making appointments with their…
Precision medicine has started to offer important answers to patients with diseases that have a genetic component, but covering the costs of cutting-edge testing and emerging therapies can be a challenge. Payers are often hesitant to commit to reimbursing experimental or unproven treatment plans, and many are still on the fence about covering genetic testing,…
Telemedicine Waivers for ACOs and Expanded Stroke Coverage in the Fiscal Year 2018 Appropriations Bill On February 9, President Trump signed the Bipartisan Budget Act of 2018 (H.R.1892). Although the bill primarily  provides fiscal year (FY) 2018 appropriations for continuing projects and activities of the Federal Government through Friday, March 23, 2018, it also includes…
Seventy percent of executives participating in a survey conducted by Humana and HFMA believe that the need for interoperability and seamless data sharing will be required for payers and providers to succeed with value-based care. The Value-Based Payment Readiness Survey found that a majority of healthcare executives have noticed gaps in their data sharing and…
State governments are experimenting with requirements and incentives for Medicaid accountable care organizations to address social determinants of health. Government executives say Medicaid ACO programs offer several key leverage points for addressing disparities and social determinants, including partnership and care management requirements, quality metrics and financial incentives. Here are some examples of efforts under way:…
From 2013 to 2016, Medicare Shared Savings Program accountable care organizations (ACOs) improved quality. Continued infrastructure development funding, better relationships with postacute care facilities, and shared learnings among diverse ACOs would maximize quality improvement. ABSTRACT Objectives: To investigate accountable care organization (ACO) quality improvement over the first 4 Medicare Shared Savings Program (MSSP) years. Study…