On Wednesday, Aug 25, leaders at the Washington, D.C.-based NAACOS—the National Association of ACOs—trumpeted the progress of accountable care organizations in saving money for the Medicare program, one day after joining eleven fellow national healthcare associations in pleading with members of Congress to include legislation supporting alternative payment model acceleration in upcoming federal legislation. On…
Keeping within expenditure limits is a top priority for most ACOs for Medicare. That makes sense. Savings are the main distinguishing feature of an ACO arrangement, as opposed to straight Fee-for-Service reimbursement. ACOs that accept downside risk can’t afford to exceed the expenditure target. It’s in their best interest to create initiatives to cut costs…
New bipartisan House legislation aims to boost the amount of shared savings that accountable care organizations can receive from the federal government to halt a slide in participation that has occurred over the past two years. The Value in Health Care Act reintroduced on Tuesday includes new requirements to study health outcomes for Medicare beneficiaries…
After the 2020 election, we predicted seven trends to expect in Value-Based Care. Our forecasts were right on track. Last week the Biden Administration released its first Physician Fee Schedule and Quality Payment Program Proposed Rule, a 1,747-page document that promotes restructured value-based care initiatives. As we predicted, it recognizes both a significant health equity…
In less than a decade, accountable care organizations (ACOs) have grown from nothing to caring for nearly 20% of all Medicare beneficiaries. Throughout this period of remarkable growth, quality improvement has been a critical component of Medicare ACO programs. A set of predefined quality measures incentivizes doctors, hospitals, and other providers in an ACO to provide…
Physician groups are calling the Medicare Physician Fee Schedule proposed rule a mixed bag for practices, which now face a potential reduction in physician reimbursement next year, among other changes. “The proposed 2022 Medicare Physician Fee Schedule (PFS) represents a mixed bag for physician practices,” Anders Gilberg, senior vice president of government affairs at the…
The American Medical Group Association (AMGA) recommended several steps regarding accountable care organization (ACO) financial risk advancement in the Medicare Shared Savings Program (MSSP) in a letter to CMS. CMS’ decision to defer the automatic advancement of ACOs in the MSSP and allow ACOs to remain in their current risk level of the BASIC Track’s…
Doctors in accountable care organizations (ACOs), and those thinking of starting or joining one, have had their hands full keeping up with changes in the way Medicare is administering them. ACOs are groups of doctors, hospitals, and/or other healthcare providers that work together with a goal of providing better care at lower cost. As part…
The Medicare Access and CHIP Reauthorization Act (MACRA) has neither fueled growth in alternative payment models (APMs) nor has it imposed any significant payment differential based on value in the Merit-based Incentive Payment System (MIPS). Currently, the maximum increase MIPS offers is 1.86%, and in 2018, nearly all (98%) eligible clinicians had a positive MIPS…
Accountable care organization (ACO) growth has hit a snag again, with the COVID-19 pandemic impacting the number of ACOs in public and private contracts, according to a new analysis. The analysis published in the Health Affairs blog found that ACO growth has plateaued over the last couple of years, starting in 2019 when CMS introduced…