Unbiased Analysis of Today's Healthcare Issues
Medicare’s Shared Savings Program (MSSP) contracts with accountable care organizations (ACOs) to provide care for Medicare beneficiaries. Reimbursement levels for these ACOs depends on quality and their ability to generate cost savings relative to the non-ACO national trend. The goal is to align provider and payer incentives in improving quality and reducing cost. Would such a…
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…
This quote is from David Blumenthal, a physician and former Harvard Medical School professor, who was the national coordinator for health information technology between 2009-2011. He describes in an interview for the Atlantic why adoption of electronic medical records has been so slow in the U.S. From the patient’s perspective, this is a no-brainer. The benefits…
Maybe. An press release from CMS is very upbeat on ACOs. What do the numbers say? Farzad Mostashari and Ross White review the CMS report and find that results were mixed: Of the 114 ACOs in the program, 54 of the ACOs saved money and 29 saved enough money to receive bonus payments. The 54…
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…
Health reform not only changes the health care market for the demand side (e.g., patients, insurers), but also for the supply side (e.g., hospitals, physicians). In the Medicare setting, a number of initiatives have aimed to pay providers who provide high-quality or low-cost care more money, and pay providers who provide low-quality or high-cost care…
Health Reform’s Accountable Care Act (ACA) mandates the creation of Accountable Care Organizations (ACOs). Dartmouth researcher Elliott Fisher stimulating much of the interest in ACOs by introducing the concept of an “extended hospital medical staff” at a 2006 meeting of the Medicare Payment Advisory Commission (MedPAC). Today, I review an article by Berenson and Burton (2011) describing…
Medicare recently release a request for proposal for health care agencies to participate in both the Medicare Shared Savings Program and the Pioneer Accountable Care Organization (ACO) pilot project. The Pioneer ACO project is similar to the Shared Savings Program but has higher levels of cost sharing and (in year 3 of the pilot) partially…