The introduction of Pathways to Success may behind falling accountable care organization (ACO) participation numbers, according to researchers from Leavitt Partners and the Duke-Margolis Center for Health Policy at Duke University. Using information pulled from Torch Insight, a healthcare database from Leavitt Partners Insight, the researchers reported in a new Health Affairs blogpost that there were 1,588 public…
A bipartisan pair of senators on Tuesday introduced a bill to fix the so-called “rural glitch” in the CMS’ reimbursement formula for accountable care organizations and potentially increase reimbursement rates for ACO providers under the Medicare Shared Savings Program. The Rural ACO Improvement Act, sponsored by Sens. Catherine Cortez Masto (D-Nev.) and Pat Roberts (R-Kan.), aims to…
In December 2018, the Centers for Medicare and Medicaid Services (CMS) announced a major overhaul of the Medicare Shared Savings Program (MSSP) by finalizing Pathways to Success. This was one of the largest changes to the Medicare ACO program since its initiation, with the most visible change being the shorter timeframe for ACOs to transition to…
Creating a good Patient Experience in health care has gained little traction, despite being touted as one of the Triple Aim’s key goals in Value-Based Health Care. Health systems have been more focused on how to increase patients via health plan negotiations and consolidating regional providers, rather than focusing on the slower paced process of…
New analysis from Avalere finds that physician-led accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) outperformed hospital-led ACOs by a significant margin. Additionally, MSSP ACOs continue to achieve higher savings the longer they participate in the program. The MSSP is Medicare’s largest alternative payment model and seeks to transition Medicare away from fee-for-service payment…
Accountable care organization (ACO) success was no stranger to physicians at Advocate Health Care and Aurora Health Care. Now that the two major health systems are combined, the new organization’s three affiliated ACOs are continuing on the path to improved care quality at lower costs. CMS reported earlier this month that ACOs in the Medicare Shared Savings…
Physician-led accountable care organizations generated nearly seven times more savings for Medicare last year compared to more high-revenue ACOs typically led by hospitals, a new analysis finds. The analysis released Tuesday from the consulting firm Avalere found that low-revenue ACOs, which are typically led by physicians, generated $180 in Medicare savings per beneficiary in 2018….
As the industry transitions from the fee-for-service model to value-based care, many providers are finding themselves struggling to straddle the divide. The shift away from volume has created many new administrative burdens that are handicapping providers’ ability to focus on patient care. In an effort to alleviate these significant provider burdens, CMS recently sent out…
In recent articles, we’ve discussed how Value-Based Health Care must help consumers make good decisions. Equally as important, CMS is now emphasizing how physicians should serve as navigators for their patients, providing information and guidance. Let’s take a closer look at how the triad of primary care physician, specialist consultant, and patient can effectively engage in…
Many of the top health system and provider groups lauded the Department of Health and Human Services’ (HHS’) proposed regulations aimed at updating the decades-old Stark Law saying they believe it is the start to removing major regulatory headaches stymying the shift to value-based care models. The Centers for Medicare & Medicaid Services (CMS) and…