For 10 years, the agency that runs Medicare has offered doctors and their practices extra money if they joined groups called Accountable Care Organizations and improved the quality of care they provided to older patients covered by traditional Medicare, while also focusing on the cost of their care. But a new study finds that those…
Are 66 new accountable care organizations (ACOs) in a year a sign of progress or a disappointing result? That depends on who you ask. CMS announced last week that 66 additional ACOs joined the Medicare Shared Savings Program (MSSP) for ACOs in 2022, bringing the total up to 483 ACOs. However, that number is only…
Medicare’s Accountable Care Organization (ACO) Investment Model (AIM) provided up-front funding to forty-one small, rurally located ACOs to encourage their participation in the Medicare Shared Savings Program. We estimate net savings to Medicare of $381.5 million over three years, driven by utilization reductions in inpatient and other institutional care and by the absence of shared…
Accountable care organizations (ACOs) in the Medicare Shared Savings Program will care for more beneficiaries in 2022, making it the largest alternative payment model in Medicare despite lackluster ACO participation numbers this year, according to new program data from CMS. Over 11 million Medicare beneficiaries will be attributed to a provider practicing as part of…
More Medicare beneficiaries will receive care from providers in Medicare Shared Savings Program accountable care organizations this year, but the number is still lower than it was in 2020, new data show. Nearly 1 in 5 Medicare enrollees will be treated by Shared Savings Program ACO providers this year, a slight increase from 2021 but lower…
Medicare population-based payment models, broadly known as accountable care organization (ACO) models, of which the Global and Professional Direct Contracting Model (GPDC) is an example, were launched out of recognition of two largely inherent weaknesses of fee-for-service: FFS does not promote efficiency, nor does it promote equity. The Centers for Medicare and Medicaid Services (CMS)…
The question of whether ACOs should be forced to accept “downside risk” — in effect pay a penalty if they exceed certain spending benchmarks — has bedeviled CMS’ ACO programs and ACO programs in general. Seema Verma, the Trump administration’s CMS director, pushed for more downside risk, and the administration’s Pathway to Success program shortened…
Your health care organization may be on the tightrope of still coping with COVID-related illness and delivering essential patient care, amidst staffing and supply shortages. But in 2022, life is not poised to give health care a breather. Likewise, there is no slow-down to the expansion of Value-Based Care and payment models or development of…
Accountable care organization (ACO) success depends in part on a broad network of health information exchange (HIE) partners to effectively coordinate care. Our study illustrates that although ACO participation broadens HIE networks, the effects accrue differently across markets with varying levels of ACO penetration. ACO hospitals in high–ACO penetration markets increase their HIE network breadth…
As we reported on Wednesday, Jan. 12, “The top officials at the federal Centers for Medicare and Medicaid Services (CMS) on Tuesday, Jan. 11, made a major public statement regarding the goal of moving the healthcare system towards health equity, and a major component of that statement focused on leveraging Medicare’s value-based programs, particularly those…