Accountable Care Organizations who are at risk of owing money back to Medicare because they haven’t met spending targets on shared-risk beneficiaries now have more freedom to use telehealth. Under a guidance document released last month by the Centers for Medicare & Medicaid Services, ACOs participating in a Medicare Shared Savings Program that is under…
Accountable care organizations have major challenges integrating social services with medical care, including a lack of data on their patients’ social needs and the capabilities of community partners. That’s the finding of a new study published in the journal Health Affairs, based on qualitative data from 22 ACOs. “The ACOs in our sample frequently lacked data about several…
The Next Generation Accountability Care Organization Program appears to be on shaky ground as the Trump administration questions its capacity to generate savings and a potential replacement revs up. The five-year demonstration program will expire at the end of 2020 unless the Department of Health and Human Services Secretary Alex Azar decides to extend it or make…
Despite agreement that the social determinants of health (SDOH) can impact accountable care organization (ACO) success, many see challenges in integrating interventions into practice, according to a new study published in Health Affairs obtained ahead of print by journalists. Specifically, ACOs face challenges in collecting data about patients experiencing key SDOH, creating meaningful community health partnerships, and…
Despite interest in addressing social determinants of health to improve patient outcomes, little progress has been made in integrating social services with medical care. We aimed to understand how health care providers with strong motivation (for example, operating under new payment models) and commitment (for example, early adopters) fared at addressing patients’ social needs. We…
The world of healthcare is quickly migrating from a fee-for-service (FFS) reimbursement model to value-based care. But for accountable care organizations (ACOs) comprised of multiple independent providers, making the transition to value-based care can be especially complex. Working with disparate electronic medical records (EMRs) across a wide range of care settings and specialties, these organizations…
The ability for ACOs to continue to perform year over year requires strategies that allow for changes in healthcare delivery. In this webinar, Dr. Lawrence Schimmel, Chief Medical Officer of Clinigence Health, will provide audiences with insight on how to meet and exceed performance benchmarks. From stratification of patient populations to provider performance reports,…
As the millennium’s third decade begins, Risk has taken hold as THE strategy for tackling health care costs. Virtually overnight (in health care years) the industry has moved—albeit not uniformly—to accept Risk. This transition is already beginning to impact hospitals and hospital-based systems, and raises serious questions about the viability of their role as the…
More accountable care organizations are taking on downside financial risk in the Medicare Shared Savings Program than ever before, with 37% in the program today participating in these arrangements. This is a notable increase in the number of downside-risk ACOs, according to an analysis from Avalere Health. By comparison, just 10% of ACOs assumed downside risk…
In its first two years, the Next Generation ACO model was not linked with reduced net Medicare spending, and had no effect on use or spending for hospitalizations, according to a new evaluation of the government program. Five things to know: 1. In its second evaluation report of the Next Generation ACO model, researchers from the University…