Pathways To Success: A New Start For Medicare’s Accountable Care Organizations

August 9, 2018Garrett SchmittNo CommentsACO, ACOs, Medicare, Medicare Shared Savings Program, Seema Verma

For many years we have heard health care policymakers from both political parties opine about the need to move to a health care system that pays for the value of care delivered to patients, rather than the mere volume of services. While disagreements may arise on how we get to value, the need for this…

CMS plans to ‘retire’ some ACOs

August 9, 2018Garrett SchmittNo CommentsACO, ACOs, CMS, Medicare Shared Savings Program, MSSP, MSSPs

The CMS wants to eliminate zero and low-risk tracks for accountable care organizations to more quickly move them to downside risk. The agency announced Thursday that it is planning to overhaul the Medicare Shared Savings Program by scrapping Track 1 and Track 2 and will launch a Basic track that provides a smaller window for…

ACOs With Risk-Bearing Experience Are Likely Taking Steps to Reduce Low-Value Medical Services

July 17, 2018Garrett SchmittNo CommentsACOs, Cost Containment, Cost Reduction, low value, Risk, Risk Bearing, Survey

ABSTRACT: Objectives: Accountable care organizations (ACOs) are groups of healthcare providers responsible for quality of care and spending for a defined patient population. The elimination of low-value medical services will improve quality and reduce costs and, therefore, ACOs should actively work to reduce the use of low-value services. We set out to identify ACO characteristics…

ACOs and Rural Healthcare

June 22, 2018Garrett SchmittNo CommentsACOs, MSSP, MSSPs, Rural

Roughly 20 percent of the United States population lives in rural areas. Despite this, rural America faces a number of health-related challenges, some of which are structural, while some are related to regional differences in health and health care in this country. Compounding these issues, incomes are lower and poverty rates are higher in many…

RECORDED WEBINAR: Transitioning Into a Successful Risk-Based ACO – Part 2: How to Prepare For Risk

June 19, 2018Garrett SchmittNo CommentsACO, ACOs, APM, Downside Risk, MACRA, Reinsurance, risk management, Risk Strategies, Surety Bonds, Webinar, webinars

Download Slides  This is Part 2 of a two part series and was recorded on 6/19/2018. As with Part 1, this webinar will be informative for those considering taking risk in an ACO,  specifically Track 1 ACOs considering moving to a risk-based model in 2019. What was covered in this session: The standoff between…

States consider Medicaid ACOs to remedy unsustainable spending: 4 things to know

June 15, 2018Garrett SchmittNo CommentsACOs, Kaiser, Medicaid, Medicaid ACOs

Medicaid payments are increasingly becoming state budget busters as the program covers frequent emergency room admissions and outpatient tests, according to Kaiser Health News. Here are four things to know about why some states are turning to Medicaid ACOs to alleviate financial load: 1. Minnesota is one of the states that has implemented an ACO…

Accountable Care Organizations Want The Rewards But Few Want The Risk

June 13, 2018Garrett SchmittNo CommentsACOs, Downside Risk, Medicare, Risk

Accountable care organizations, are a new organization of healthcare, combining some aspects of insurance and health systems. They are collaborations which are paid a capitated rate, based on risk, and provide all care to these beneficiaries. If they show savings beyond what they are paid, they receive about half as an “incentive.” Savings cannot be…

RECORDED WEBINAR: Transitioning Into a Successful Risk Based ACO Part 1: Why Move to Risk & How to Protect Your ACO

June 5, 2018Garrett SchmittNo CommentsACO, ACOs, APM, Downside Risk, MACRA, Reinsurance, risk management, Risk Strategies, Surety Bonds, Webinar, webinars

Download Slides  Recorded on 6.5.18, this webinar will be informative for those considering taking risk in an ACO, specifically Track 1 ACO’s considering moving to a risk-based model in 2019. What is covered: Risk taking in the context of MACRA The move toward ACO risk: results & analysis Financial protection for your ACO View Part…

Seema Verma hints at the end of ‘upside-only’ ACOs

May 15, 2018Garrett SchmittNo CommentsACO, ACOs, MSSP, MSSPs, Seema Verma, Upside only

As the healthcare industry continues the march toward value-based care, CMS has turned a critical eye on one-sided ACO contracts for driving up costs and making little progress toward value. “These ACOs are actually increasing Medicare spending, and the presence of these ‘upside-only’ tracks may be encouraging consolidation in the marketplace, reducing competition and choice…

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