Unbiased Analysis of Today's Healthcare Issues
Accountable Care Organizations (ACOs) aim to use coordinated care to increase quality and lower cost. While everyone likes the sound of integrated care, it may be less clear how ACOs are aiming to achieve these goals. In a recent Health Affairs blog post, Micklos and co-authors review one study found that: …Next Gen ACO participants…
CMS is increasingly moving to alternative payment models whereby providers are paid based on their ability to improve/maintain quality and hold the line on cost. A key question then, is how does CMS evaluate quality of care? Today, the Healthcare Economist will answer this question for the case of Medicare’s Shared Savings Program (MSSP), which…
That is the finding from a recent study by Mahajan et al. (2018). The authors use data from the American Community Survey between 2011. They compare hours worked and the share of physicians who were self-employed over time. To determine whether any changes were correlated with increaed Accountable Care Organization market share, the authors examined…
Accountable Care Organizations aim to improve quality and reduce cost through an integrated care model. The theory is that by coordianting care better across different provider specialties and care settings, patients care improves. In order to coordinate care, however, you need data. In order for payers to provide higher reimbursement to high quality/low cost ACOs,…
In recent years, payers have moved towards shifting more financial risk to providers. One of the most significant ways financial risk is passed to providers is through the creation of Accountable Care Organizations (ACOs). The biggest ACO program is Medicare’s Shared Savings Program (MSSP). Are ACO’s improving quality and reducing cost? A paper by Schulz,…
ACOs are all the rage, but what does a typical ACO look like ? A study by Shortell et al. (2014) attempts to answer this question using data from the National Survey of ACOs. This survey includes ACOs participating in Medicare, Medicaid, or commercial payer programs. The authors consider eight attributes for creating an ACO taxonomy…
For most managed care plans, beneficiaries elect to participate in the plan. In exchange, beneficaries often have lower premiums, but often restricted access to providers (e.g., referral requirements, copayment differentials for out-of-network physicians). Medicare’s Accountable Care Organizations (known as Shared Savings Plans (SSP)) also assign beneficaries to organizations. The SSPs are groups of providers that…
I have written numerous posts about the pros and cons of Accountable Care Organizations. In 2012, Medicare begame allowing providers to form ACOs. An article by Pope and Kautter provides an overview of the initiative. The Medicare program, which covers the elderly and disabled, is the largest medical insurance system in the USA. One major…
Massachusetts legislature passed a first-in-the-nation bill limits the growth of health care costs in the state. “The bill would not allow spending on health care to grow any faster than the state’s economy through 2017. For five years after that, any rise in health care costs would need to be half a percentage point lower…