Accountable Care Organization

Serving High-Need, High-Cost Medicare Patients

With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such [...]

iqtsupport2017-02-15T06:00:53-05:00February 15, 2017|Accountable Care Organization, ACO, Medicare|

Participation in Alternative Payment Models Rises

In 2017 nearly 360,000 clinicians will participate in Medicare and Medicaid Alternative Payment Model programs sponsored by the Centers for Medicare & Medicaid Services. CMS also reports that this year 570 accountable care organizations, including 131 that bear risk, will serve more than 12.3 million Medicare and Medicaid beneficiaries. In addition, nearly 3000 primary care practices will participate in advanced primary care medical home models Find more about the growth of participation in CMS’s alternative payment models, including descriptions of the different models and breakdowns in the numbers of participants, in this CMS news release.

iqtsupport2017-01-27T06:00:22-05:00January 27, 2017|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, Medicaid, Medicare|

ACOs Serving Low-Income and Minority Patients Underperform

Accountable care organizations that serve large numbers of minority patients score lower on Medicare quality measures than other ACOs, a new study has found. According to the study, ACOs serving larger numbers of minority patients perform worse than other ACOs on 25 of 44 Medicare performance measures – and that performance does not improve over time. The study also pointed out that the minority patients served by ACOs are generally poorer and sicker than other ACO participants. Learn more about these and other findings in the report “ACOs Serving High Proportions of Racial and Ethnic Minorities Lag in Quality Performance,” [...]

iqtsupport2017-01-18T06:00:56-05:00January 18, 2017|Accountable Care Organization, ACO, Medicare|

Urban Hospitals in ACOS Better at Reducing Some Readmissions Rates

A new study has found that hospitals located in metropolitan areas that participate in accountable care organizations are doing a better job than other hospitals of reducing 30-day readmissions rates for Medicare patients who originally were discharged into skilled nursing facilities. It appears this improved performance can be attributed to two things: better discharge planning and better coordination with the skilled nursing facilities. To learn more go here to see the study “ACO-Affiliated Hospitals Reduced Rehospitalizations from Skilled Nursing Facilities Faster Than Other Hospitals.”

iqtsupport2017-01-17T06:00:47-05:00January 17, 2017|Accountable Care Organization, ACO, hospitals, Medicare|