CMS closed 2018 with a farewell to upside-only ACOs. Perhaps the biggest surprise in the “Pathways to Success” Final ACO Rule is its consistency with the Proposed Rule, which floated the revamped ACO Track back in August. Citing superior performance among two-sided participants, as well as the belief that upside-only tracks reduce patient choice and increase costs,…
We are quickly heading to the value-based purchasing tipping point, according to the Vice President of Network Management at Health Partners Plans in Pennsylvania. “While adoption rates are still relatively low in some regions of the country, almost all health plans and providers are doing work in this space and the percentage of spending in…
Medicare accountable care organizations accepting downside financial risk will have easier access to CMS waivers of the rule requiring three-day inpatient stays before patients can be sent to skilled nursing facilities. In a guidance published Monday, the CMS laid out requirements for Shared Savings Program ACOs that apply for a waiver of the three-day stay rule. Only…
With the publication of the Medicare Shared Savings Program (MSSP) Final Rule on December 21, the Centers for Medicare & Medicaid Services (CMS) clearly signaled that the Trump administration is serious about holding accountable care organizations (ACOs) in Medicare more financially accountable for costs and quality. However, Medicare ACOs may not be the only ACOs affected by this change….
Download Pathways to Success Planning Matrix Download Slide Deck Covered in this 60 minute webinar: NOIA & Application Timeline Pathways to Success – overview Alex Azar & Seema Verma on risk ACO Alternatives How to achieve Shared Savings and more….
Five percent of the U.S. population has complex medical and behavioral or social needs, but this group accounts for 50 percent of the country’s health care spending. New payment and care delivery models such as accountable care organizations (ACOs) have prompted decision-makers at health care delivery systems to seek the best ways to meet these patients’…
Patients who used telemedicine to check in with providers after vascular surgery demonstrated higher care satisfaction than peers discharged under normal care processes, according to a study published in Annals of Vascular Surgery. For the study, researchers examined the outcomes and recovery process of 30 vascular surgery patients in Appalachia who all had surgical incisions…
MSSP includes 561 ACOs and serves more than 10.5 million Medicare beneficiaries. CMS data credited MSSP with saving a net $314 million to the Medicare Trust Fund in 2017. The agency now wants providers to take on more risk. However, the agency faces an industry not keen on the downside of value-based contracting. In fact,…
Value-based care is nudging the half-way mark as more and more payers and providers shift their contracts away from fee-for-service arrangements, according to the Health Care Transformation Task Force (HCTTF). In a new report, the Task Force states that by the end of 2017, 47 percent of its 14 members’ business was tied to some…
Accountable care organizations (ACOs) assuming the highest levels of financial risk in Medicare saved $164 million during their second performance year, CMS recently reported. Medicare ACOs bring together groups of physicians, hospitals, and other healthcare providers and suppliers to voluntarily deliver higher-quality care at lower costs to Medicare fee-for-service patients. The Next Generation program is…