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Coordination Without Consolidation? Options for ACOs

September 14, 2021Garrett SchmittNo Commentsaccountable care, accountable care organizations, ACO, ACOs, consolidation, coordination

Accountable care organizations (ACOs) have been a large part of the transition away from fee-for-service payments, with the number of ACOs rapidly growing over the past decade. However, there has been a plateau in the number of ACOs since 2018, with ACO exits outweighing entrants for the past 2 years.1 From our analysis of Medicare Shared…

Should we do away with ACOs? The answer depends on who you ask

September 6, 2021Garrett SchmittNo Commentsaccountable care, ACOs, CMMS, CMS

Though accountable care organizations have been around for more than a decade, their effectiveness at reducing healthcare costs remains a highly debated issue, prompting impassioned condemnations and defenses from experts in the industry. A new study has stirred up the pot once again. The goal of ACOs, that is, entities that take responsibility for the quality and…

Characteristics and Performance of ACOs and Accountable Physician Groups: What Does the Evidence Tell Us?

September 1, 2021Garrett SchmittNo Commentsaccountable care, accountable physician groups, ACOs

The Council of Accountable Physician Practices (CAPP) engaged the Institute for Accountable Care (IAC) to review recent literature to assess the current state of research on the characteristics and performance of accountable care organizations (ACOs) and accountable physician groups. CAPP has promoted five elements as essential to accountable care: coordinated care, outcomes-based payment, health information technology,…

New ACO Playbook: 3 Strategies To Tackle Hidden Costs Of Specialty Care

August 25, 2021Garrett SchmittNo Commentsaccountable care, ACO, ACOs, CMS, cost data, cost variation, healthcare costs, hospital admissions, specialty care, specialty physicians

Your ACO’s most significant costs may seem obvious. CMS and most ACOs have put an enormous emphasis on reducing utilization of hospital facilities and nursing home care to control costs. But your real key to cost reduction is knowing what drives avoidable admissions and stays in the first place. And with 50-60 percent of costs…

Cost Savings Aren’t The Only Objective For ACOs: Growth Matters, Too

August 24, 2021Garrett SchmittNo Commentsaccountable care, ACO, ACO Growth, ACOs, CAHPS, cost savings, episodic bundles, Medicare, Medicare ACOs, MSSP, new patients, Patient Loyalty, Patient Population, Patient Retention, Patient Satisfaction, voluntary commitment

Keeping within expenditure limits is a top priority for most ACOs for Medicare. That makes sense. Savings are the main distinguishing feature of an ACO arrangement, as opposed to straight Fee-for-Service reimbursement. ACOs that accept downside risk can’t afford to exceed the expenditure target. It’s in their best interest to create initiatives to cut costs…

What ACOs should do now that CMS won’t extend the Next Gen ACO model through 2022

August 23, 2021Garrett SchmittNo Commentsaccountable care, ACO, ACOs, CMS, Next Gen, Next Generation, Next Generation ACOs, Next Generation model

Accountable care organizations (ACOs) were understandably disappointed in mid-May when the Centers for Medicare and Medicaid Services (CMS) announced that its Next Generation ACO Model would not be extended into 2022. Launched in 2016, the CMS model provides experienced ACOs with a way to assume higher financial risks and rewards offered through the Medicare Shared…

ACO Participation May Keep SNFs ‘In the Game’

August 8, 2021Garrett SchmittNo Commentsaccountable care, accountable care organizations, ACOs, skilled nursing facilities, SNFs

Although accountable care organizations (ACOs) have never been particularly popular among skilled nursing facilities, timing may be ripe to take on more risk to stay competitive in the market. ACO participation may help operators maintain referrals when so many potential residents are being diverted to home health care, hospice and other tracks along the continuum…

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