Some believe that an ACO’s leadership structure predicts its success. They point to differing savings results for physician-led versus hospital-led ACO shared savings models (MSSPs) to make their case. In particular, they make the argument that future Value-Based Care (VBC) policies should benefit the growth of successful physician-led ACOs, protecting them from policies that force…
Central to the controversy about ACOs’ potential for Value-Based Care is whether they actually save enough money and reduce costs fast enough. Researchers and advocates have produced various independent studies of ACO savings, the most generous estimating $1.8 billion in cumulative savings over the first three years of the program, almost double CMS estimates. Many…
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…
A lot has happened in health care since 2012, when final rules permitted provider-organized ACOs to be the driving force of Value-Based Care under the 2010 Affordable Care Act (ACA). As we pass the ACA’s eleventh anniversary, a dwindling number of Medicare Shared Savings Program (MSSP) ACOs are entering a new phase marked by higher…
When CMS first announced new primary care payment models in April 2019, ACOs understood that their future might be threatened by competition for both physicians and patients. If medical groups could independently contract with Medicare under these models, they would have the advantage of greater control over their physician network, referral arrangements, and clinical decisions….
Today, as we confront a viral threat that is challenging our health system, its capacity, and how care is financed, it seems appropriate to review some fundamentals. Health care reform has been speeding down a particular track, changing how health care is covered, paid, delivered, and organized. These reforms may seem to be about health…
The medical assistant-only model for primary care staffing may be the most cost-effective for practices relying on fee-for-service revenue, but the model will not be able to support value-based care and other sophisticated revenue arrangements, Premier recently reported. In a new analysis of 2018 data from 257 family medicine and primary care practices, the healthcare improvement…