ACOs and VBP

Accountable Care Organizations aim to link providers through the supply chain (i.e., hospitals, physicians, post-acute care facilities) to incentivize providers to improve quality and reduce costs.  In addition to its ACO program (the Medicare Shared Savings Program), the Centers for Medicare and Medicaid Services (CMS) have implemented a number of value-based payment programs, including the…

Who are the high-cost patients?

Accountable care organizations are responsible for managing the quality and cost of patients.  However, a small share of patients make up a large share of health care cost.  How can ACOs improve the care and reduce the cost of these patients? First, ACOs need to understand the needs of high-cost patients.  A perspective by Powers and…

Changes in the MSSP program

Medicare’s ACO program–the Medicare Shared Savings Plan (MSSP)–has recently been revised.  AJMC reports that Patrick Conway, MD, MSc, deputy administrator for innovation and quality and chief medical officer at CMS, describes the proposed changes to the Medicare Shared Savings Program and how they will assist accountable care organizations transitioning to tracks with more risks.

ACO Characteristics

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,…

Does your doc want to be in an ACO?

The answer is likely “It depends.”  To see why this is the case, let us consider the case of some proposed health reforms in Switzerland to force physicians into managed care (MC) networks.  As described in Rischatsch (2015): In 2012, Switzerland held a referendum…aimed at encouraging the nationwide development of MC networks. Among other changes…the legal…

The Next Generation ACO

Medicare currently has two Accountable Care Organizations (ACOs)–the more popular Medicare Shared Savings Program (MSSP) and the Pioneer ACO program. However, these ACOs have generated only limited cost savings. Only 11 of 23 Pioneer ACOs and 58 of 220 MSSP participants generated cost savings. To address some provider concerns and due to the limited cost…