Unbiased Analysis of Today's Healthcare Issues

A glitch in ACO beneficiary assignement?

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 […]

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Accountable Care Organizations in Medicare

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 […]

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