A team of health policy researchers is arguing that, in order to optimize the Medicare Shared Savings Program (MSSP), policy leaders need to think in more complex, nuanced ways about the framework and goals of the program for accountable care organizations (ACOs). Writing in the Health Affairs Blog, Michael McWilliams, M.D., Ph.D., and Alice Chen, Ph.D….
Managing risk requires collaboration among the clinical and operations teams to develop effective approaches to improving the quality and cost of care. Experienced Medicare Advantage plans can share valuable lessons with organizations interested in improving their ability to meet clinical and financial performance targets, and managing downside risk. Join us for a discussion with…
The term accountable care organization (ACO) dates back to at least 2006. The Affordable Care Act then made ACOs a fast-growing trend thanks to the Centers for Medicare and Medicaid Services (CMS) launching its Shared Savings Program in 2012. Since then, ACOs have been at the forefront of the value-based care model transition, taking incremental steps…
Dive Brief: The number of Medicare Advantage members enrolled in plans with value-based payment designs more than tripled from 2019 to 2020, CMS said Thursday. Approximately 1.2 million beneficiaries joined plans in the Value-Based Insurance Design Model for coverage next year offered by 14 MA organizations across 30 states and Puerto Rico. That’s up from…
The Centers for Medicare and Medicaid Services (CMS) recently announced that Accountable Care Organizations (ACOs) saved Medicare $739.4 million in 2018, up from $314 million in savings the year before. Those savings were achieved despite policies that Rooke-Ley and colleagues argue in a recent Health Affairs Blog post disadvantage ACOs relative to Medicare Advantage (MA) plans. Their analysis concludes that ACOs cut costs…
Creating a good Patient Experience in health care has gained little traction, despite being touted as one of the Triple Aim’s key goals in Value-Based Health Care. Health systems have been more focused on how to increase patients via health plan negotiations and consolidating regional providers, rather than focusing on the slower paced process of…
The Medicare Shared Savings Program, which governs the majority of Medicare accountable care organizations (ACOs), and Medicare Advantage are gaining in popularity. But the former is saving taxpayers, while the latter is incurring costs, a new report in Health Affairs finds. “Our examination of the literature indicates that Medicare Advantage ‘costs’ Medicare; that is, when a beneficiary joins MA,…
The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on…
Medicare Advantage insurers added 1.4 million members to their rosters for 2019 coverage, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But Advantage membership is growing at slower pace compared with previous years. According to the latest federal data showing enrollment as of this month, 22.4…
Medicare Advantage is a growing market and an attractive opportunity for payers to offer quality plans to older beneficiaries. Competition is increasing in the MA environment, and beneficiaries have more options than ever to meet their coverage needs. With more choice comes higher rates of disenrollment as members select the most valuable plans for their…