ACO – Page 5 – DeBrunner & Associates

Next Generation ACO Nets Savings

Medicare’s Next Generation Accountable Care Organization model saved taxpayers $62 million in 2016, or 1.1 percent of the spending of the participating organizations, the Centers for Medicare & Medicaid Services has announced. The program also reduced hospitalizations 1.3 percent. In all, 18 organizations participated in the model program in 2016. Among them, four organizations accounted for more than half of the savings. In 2015, 45 organizations participated in the model and 51 are participating this year. Under the Next Generation ACO model, participants assume greater financial risk for their performance than under other Medicare models but also are eligible to [...]

iqtsupport2018-09-04T06:00:50-04:00September 4, 2018|Accountable Care Organization, ACO, Medicare|

MedPAC Issues 2018 Report to Congress

The non-partisan legislative branch agency that advises Congress and the administration on Medicare payment policies has submitted its mandatory annual report to Congress. Among the findings included in the report by the Medicare Payment Advisory Commission are: Medicare’s hospital readmissions reduction program has not resulted in increases in emergency room visits or hospital observation stays. Many Medicare accountable care organizations, while maintaining or improving quality, are producing more modest savings than predicted. MedPAC approves of Medicare’s proposals to redesign the case-mix classification system for skilled nursing facilities. MedPAC supports changes Medicare has proposed for patient assessment and therapy requirements for [...]

iqtsupport2018-06-21T10:33:14-04:00June 21, 2018|Accountable Care Organization, ACO, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, MedPAC, post-acute care|

ACOs Moving Into Medicaid

Accountable care organizations, one of the centerpieces of recent Medicare efforts to test new ways to deliver care more effectively and at less cost, are finding their way into state Medicaid programs as well. Today, a dozen states employ Medicaid ACOs and another ten are planning to do so. Learn more about Medicaid ACOs, and how one state (Minnesota), in particular, is using them, in this Kaiser Health News report.

iqtsupport2018-06-19T06:00:58-04:00June 19, 2018|Accountable Care Organization, ACO, Medicaid|

MedPAC Meets

Last week the Medicare Payment Advisory Commission held two days of public meetings in Washington, D.C. During the sessions MedPAC, a non-partisan legislative branch agency that advises Congress on Medicare payment issues, addressed the following subjects: a Medicare Advantage status report a Medicare prescription drug program (Part D) status report hospital inpatient and outpatient payments physician payments ambulatory surgical center, dialysis center, and hospice payments post-acute care facility payments the hospital readmissions reduction program telehealth accountable care organizations Go here to see the issue briefs and presentations used during the meetings.

iqtsupport2018-01-18T06:00:18-05:00January 18, 2018|Accountable Care Organization, ACO, Medicare, Medicare post-acute care, MedPAC|

Reduced Hospitalizations and Improved Care for High-Risk Patients Not Driving ACO Savings

Medicare savings reported in the early years of the Medicare Shared Savings Program are not coming from reduced hospitalizations of high-risk Medicare patients or even through better coordination of care for those patients. Instead, Medicare accountable care organization savings are coming mostly from better and more coordinated care for low-risks Medicare ACO participants. These surprising findings are reported in the article “Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients,” which can be found in the December 2017 edition of the journal Health Affairs. Find a link to that article here.

iqtsupport2017-12-19T06:00:35-05:00December 19, 2017|Accountable Care Organization, ACO, Medicare, Medicare regulations|

Medicare ACOs Showing Promise

Medicare’s Shared Savings Program and its accountable care organizations are showing promise as a means of reducing Medicare spending and improving the quality or care. Or so concludes the U.S. Department of Health and Human Services’ Office of the Inspector General. According to a new OIG report, Over the first 3 years of the program, 428 participating Shared Savings Program ACOs served 9.7 million beneficiaries. During that time, most of these ACOs reduced Medicare spending compared to their benchmarks, achieving a net spending reduction of nearly $1 billion. At the same time, ACOs generally improved the quality of care they [...]

iqtsupport2017-09-07T06:00:13-04:00September 7, 2017|Accountable Care Organization, ACO, Medicare|

ACOs, APMs Proliferate

The number of accountable care organizations and alternative payment models is growing, as is the number of people served by such programs. According to a new study published on the Health Affairs Blog, there are more than 900 ACOs across the country – a 10 percent increase over a year ago. 32 million Americans are served by ACOs today – 2.2 million more than a year ago. Among them, 59 percent are served through commercial contracts, 29 percent by Medicare contracts, and 12 percent under Medicaid contracts. ACO growth is greatest in metropolitan areas, the states with the greatest ACO [...]

iqtsupport2017-06-30T06:00:29-04:00June 30, 2017|Accountable Care Organization, ACO|

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|