Several years ago in the early days of Accountable Care Organizations (ACOs), we worried and warned about the importance of how each organization should divide up potential savings. In a white paper published in Physician Leadership Journal and on the Salient Web site, co-author Stephen Sheiko and I called it an “Elephant in the ACO…
On Tuesday, December 1, officials at the federal Centers for Medicare & Medicaid Services (CMS) announced changes to the Medicare payment system that will extend payment for more than 60 telehealth-delivered services, beyond the current public health emergency (PHE). The changes have been incorporated into the Calendar year 2021 Physician Fee Schedule final rule. CMS…
The COVID-19 pandemic has exposed and exacerbated existing health inequities in the United States. Black and Latinx Americans have experienced a disproportionate burden of COVID-19 infections and hospitalizations due to economic disadvantages, structural racism, and higher rates of underlying chronic conditions. Value-based payment (VBP) structures have the potential to reduce health disparities, and during the pandemic, health…
In a completely unexpected move, on November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) and the Department of Health and Human Services (“HHS”) Office of the Inspector General (“OIG”) published advance copies of a collection of four rules focusing on two themes: (i) reducing prescription drug prices and (ii) advancing the transition…
To successfully manage the 40 to 60 percent of costs of care driven by specialty physicians, your ACO must overcome one major obstacle when you begin to address specialty costs: the lack of information to guide your actions. Although ACOs have claims data to calculate total costs per ACO patient and totals for specialty services,…
The Trump administration’s push to get more Medicare Shared Savings Program (MSSP) ACOs to take on downside risk is having an effect, but there are still many non-takers. According to tallies in an analysis published on the Health Affairs blog last month, 53% of the 139 MSSP ACOs that migrated out of the regular MSSP program last…
Roji Health Intelligence and Proficient Health, in conjunction with ACO Exhibit Hall, are presenting the top 10 ways to increase specialist engagement in your ACO. We will dive into what specialist engagement is, why it is important and what your organization can do to increase engagement. Our speakers: Ms. Terry Hush – CEO of…
If CMS aims to lower healthcare costs and improve quality, then the agency should use more population-based alternative payment models, like accountable care organizations (ACOs), according to a new analysis. The analysis of the evaluations for more than a dozen CMS value-based initiatives over the past eight years showed that no other alternative payment model came…
As we reported last week, with the change of administrations that will be coming in January, the leaders of the Washington, D.C.-based National Association of ACOs (NAACOS), which represents hundreds of accountable care organizations nationwide, on Thursday, Nov. 12, published an outline of what they consider to be successful ACO models, and NAACOS’s president and…
A team of health policy researchers is arguing that, in order to optimize the Medicare Shared Savings Program (MSSP), policy leaders need to think in more complex, nuanced ways about the framework and goals of the program for accountable care organizations (ACOs). Writing in the Health Affairs Blog, Michael McWilliams, M.D., Ph.D., and Alice Chen, Ph.D….