The Medicare Shared Savings Program, the accountable care organization (ACO) model that served 10.6 million seniors in 2020, collectively saved Medicare $4.1 billion last year, and $1.9 billion after accounting for shared savings payments, according to the National Association of ACOs and as recently published in Healthcare Finance. 513 ACOs participated in the Shared Savings Program in 2020, down…
On August 25, the Centers for Medicare and Medicaid Services (CMS) released performance results for the eighth performance year (2020) of the Medicare Shared Savings Program(MSSP). The results for this year need to be interpreted carefully given that the majority of the performance year occurred during the global COVID-19 pandemic. As a result of the pandemic,…
Several medical groups say a new round of cuts to Medicare payments set to go into effect in 2022 will derail their move to value-based care and impact hiring of new staff. Medical groups spoke about the need for Congress to avert a series of cuts during a briefing on Tuesday sponsored by the American…
In August, Administrator Chiquita Brooks-LaSure and other leaders from CMS shared their priorities for the next 10 years. In particular, they called out the importance of reducing inequities in health care, striving to get all Medicare and Medicaid beneficiaries in accountable care relationships, and designing financial incentives that will encourage participation in new payment and…
As we reported in a news article on Sept. 30, “A dispute has arisen over controversial statements made by two prominent healthcare policy leaders around the Medicare Advantage program. On Sept. 30, Donald Berwick, M.D., and Richard Gilfillan, M.D., published an article in the Health Affairs Blog entitled “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2:…
Accountable care organizations (ACOs) can improve health equity in their patient populations, but they need more funding and flexibility to do so, according to a report from a group representing 370 ACOs. “ACOs are already beginning to do the work of addressing negative [social determinants of health] to improve quality and control costs for the…
Accountable care organizations (ACOs) participating in the Medicare Shared Savings Program had a record performance year in 2020. The ACOs saved Medicare $4.1 billion while achieving an average quality score of 97.8 percent. One of the health systems participating in the program—Advocate Aurora Health—led the nation in savings and quality. Advocate Aurora’s affiliated ACOs generated $110 million in…
Given an Orwellian title, Direct Contracting, launched by Center for Medicare and Medicaid Innovation (CMMI), was anything but direct. “Indirect Contracting” would have been a far more accurate name, since the cornerstone of the program was CMS’s opening the door to non-provider-controlled “Direct Contracting Entities (DCEs)” to become the fiscal intermediaries between patients and providers….
While the COVID-19 pandemic rages, the past two years have seen another epidemic of a far different type—in financing and acquisitions of firms focused on serving Medicare beneficiaries. These firms include physician practices, notably primary care practices (PCPs); management services organizations (MSOs) that aggregate practices; and Medicare Advantage (MA) insurers. In this arena, the combined…
As plans prepare for Open Enrollment (OE), it’s critical to understand what beneficiaries need as these Medicare Advantage (MA) plans look to recruit new and retain existing beneficiaries. It’s also critical for plans to understand historical data in specific regions to make appropriate expansion decisions. In this blog, we will provide insight into areas that…