New bipartisan legislation aims to fix a glitch that can penalize rural accountable care organizations that reduce costs. The legislation, introduced Tuesday, would fix a flaw that requires all ACOs to measure their performance against themselves, which lawmakers say can disproportionately impact rural providers. The bill comes as ACO advocates have been worried about a…
A softer form of health care consolidation, where independent primary care practices align in certain Medicare accountable care organizations (ACOs) to negotiate with payers, may lead to higher prices, but not to an overwhelming extent, according to a new study published Monday in Health Affairs. Researchers focused their work on independent practices joining ACOs led by…
The answer to solving a healthcare crisis that exacerbates barriers to care among some of the most vulnerable patient populations in the country is staring us in the face. For rural hospitals straining under the weight of erratic patient volumes, sicker populations and lack of funding, the path forward is in value-based care. But providers…
The Triple Aim. The Quadruple Aim. Right care at the right place at the right time. Whether one works in a hospital or small independent practice, healthcare providers are leaning on these concepts to deliver valuable care to their patients, and that is in its simplest form: care that results in the best patient outcomes…
The Medicare Shared Savings Program (MSSP) is the largest value based care program from the Center for Medicare & Medicaid Services (CMS) to date. Since its inception in 2012, Accountable Care Organization (ACO) participation has doubled; providing care to over 10 million beneficiaries, generating $1.94 billion in total savings, and earning over $1.47 billion in…
The Center for Medicare & Medicaid Innovation (CMMI) remains committed to moving the health care system towards value-based care in the early years of the Biden Administration, though the center’s leadership is doing some soul-searching on how best to pursue its mission, according to CMMI’s new director Liz Fowler. Fowler made her first public remarks…
The nationwide association dedicated to promoting the interests of the accountable care organizations (ACOs) operating across the U.S. healthcare system has sponsored research that validates the association’s contention that legislation recently introduced into Congress around ACOs and other alternative payment models (APMs), will save the Medicare program hundreds of millions of dollars a year. 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 December of 2018, the Trump Administration overhauled the largest value-based payment program in fee-for-service Medicare—the Medicare Shared Savings Program (“Shared Savings Program” for short) for “Accountable Care Organizations” or ACOs. ACOs are groups of health care providers that agree to be held accountable for the quality, cost, and experience of care for a population…
The CMS achieved savings from the Medicare Shared Savings Program last year, marking the second year in a row the agency turned a profit from the program. About 66% of the 548 Medicare accountable organizations produced a total of $1.7 billion in savings in 2018 and the CMS scored a $739.4 million gain, according to new agency…