Balancing Specialty and Primary Care Lowers Costs for ACOs

July 31, 2019Garrett SchmittNo CommentsSpecialist, Specialists

Accountable care organizations (ACOs) that provided between 40 and 45 percent of office visits through specialists had significantly lower costs compared to ACOs with the lowest and highest specialty care proportions, according to a recent University of Massachusetts Amherst study. Published in JAMA Open Network, the study of 620 ACOs in the Medicare Shared Savings Program…

Fitting Specialty Care Into ACOs

November 20, 2018Garrett SchmittNo CommentsSpecialist, Specialists

The footprint of accountable care organizations (ACO) continues to change. At the start of 2018, there are approximately 1,000 ACOs covering 32.7 million consumers—approximately 11% of the U.S. insured population (294.6 million)—under 1,477 different contracts (see After A Slow 2017, ACOs Grow & Expand Their Contracts In 2018). The coverage varies by payer. According to…

Five Strategies for Specialists: How to Safely Navigate ACO Arrangements

September 26, 2018Garrett SchmittNo CommentsSpecialist, Specialists

Amidst the furor over health care access and affordability, most consumers believe that the exceptional quality of America’s health care is due to specialty medicine. But Value-Based Health Care may well dramatically change specialty practice by putting specialists under financial risk arrangements. That’s because the most prestigious and flourishing providers in health care are also…

ACOs and Specialty Physicians: How Episodes of Care Create a Win-Win Cost and Quality Strategy

May 9, 2018Garrett SchmittNo CommentsEpisodes of Care, Specialist, Specialists

Specialty care is a thorny cost and political issue for ACOs and physicians alike. No ACO can provide good or comprehensive patient care without specialists. But if ACOs are to produce savings, they will almost certainly need to address how, when and at what cost those specialists will be used. The degree of concern about…

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