Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Accountable Care Organization

AMA, AHIP, and Others Oppose Upside-Only ACO Changes for MSSP

September 25, 2018 - The American Medical Association (AMA), Medical Group Management Association (MGMA), and Health Care Transformation Task Force (HCTTF) are among nine industry groups calling on CMS to reconsider proposed changes to the Medicare Shared Savings Program (MSSP). Proposals to shorten the time new ACOs have to assume downside financial risk from six to two years and reduce the shared savings...


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Time Helps Accountable Care Organizations Realize Savings in MSSP

by Jacqueline LaPointe

Experience is a key factor to realizing greater cost savings in the Medicare Shared Savings Program (MSSP), a new Avalere analysis found. Accountable care organizations (ACOs) in the MSSP for four or more years generated nearly all of the...

Policymakers Concerned with ACO Shared Savings Under Updated MSSP

by Jacqueline LaPointe

The House Committee on Ways and Means recently voiced concerns that proposed changes to the shared savings arrangements under the Medicare Shared Savings Program (MSSP) overhaul would harm accountable care organizations (ACOs). In a...

MSSP ACOs Saved $1.84B, Nearly Double CMS Estimate, Study Finds

by Jacqueline LaPointe

CMS estimates that accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved $954 million from 2013 to 2015. However, a new Dobson DaVanzo & Associates analysis, commissioned by the National Association...

How Next Generation ACOs Built a Foundation for Success

by Jacqueline LaPointe

Employing additional administrative staff, prioritizing care management, and building data analytics capacity were key strategies accountable care organizations (ACOs) implemented to participate in the Next Generation model, CMS recently...

More MSSP ACOs Saved Money, Earned Shared Savings in 2017

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) generated about $314 million in net Medicare savings in 2017, according to new MSSP performance data from CMS. In 2017, 472 ACOs in the largest Medicare...

CMS to Offer More Flexibility to Risk-Bearing ACOs, Verma Says

by Jacqueline LaPointe

Federal regulations and rules are commonly cited as barriers to implementing value-based reimbursement models. The rules can prevent care coordination and appropriate transitions of care, which negatively impact an accountable care...

Next Generation ACOs Save Medicare $62M, Maintain Care Quality

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the Next Generation ACO program produced nearly $62 million in net savings to Medicare while maintaining care quality in 2016, CMS recently reported in the newly released evaluation of the...

ACOs Relax Post-Acute Care Rules to Improve Care, Reduce Costs

by Jacqueline LaPointe

Ensuring patients receive the right post-acute care at the right time is key to controlling costs in accountable care organizations (ACOs) and other population-based alternative payment models. With this in mind, Vermont’s statewide...

Value-Based Experience, Robust EHR Use Key Factors to ACO Success

by Jacqueline LaPointe

A collaborative culture, prior value-based reimbursement experience, and robust EHR use are among the top factors contributing to accountable care organization (ACO) success, according to a new report from the Patient-Centered Primary Care...

After a Slow 2017, ACOs Grow and Expand Their Contracts in 2018

by Jacqueline LaPointe

The number of accountable care organizations (ACOs) continued to grow in 2018, as did the number of contracts the organizations entered, a new report from Leavitt Partners and the Accountable Care Learning Collaborative uncovered. From...

Leading Accountable Care Organization Group Opposes MSSP Overhaul

by Jacqueline LaPointe

The proposal to overhaul the Medicare Shared Savings Program (MSSP) would significantly harm the accountable care organization (ACO) movement, the National Association of ACOs (NAACOS) recently stated. “The administration’s...

CMS Plans to Transform MSSP to Encourage ACOs to Assume More Risk

by Jacqueline LaPointe

CMS recently proposed an overhaul of Medicare’s largest accountable care organization (ACO) program, transforming it from the Medicare Shared Savings Program (MSSP) to the Pathways to Success initiative. The redesigned MSSP program...

ACOs and Other Value-Based Purchasing Models Have Yet to Cut Costs

by Jacqueline LaPointe

Accountable care organizations (ACOs) and other population-based value-based purchasing models have not decreased total cost of care or generated quality improvements at the market level, a new study found. The Healthcare Financial...

Key Issues Impacting Two-Sided Risk Accountable Care Organizations

by Jacqueline LaPointe

Medicare accountable care organizations (ACOs) operating under two-sided financial risk arrangements save the federal healthcare program more than one-sided risk organizations. But policymakers must address financial incentives,...

Medicare Spending Greater on Patients in Downside Risk MSSP ACOs

by Jacqueline LaPointe

Moving accountable care organizations (ACOs) to Medicare Shared Savings Program (MSSP) tracks with downside financial risk may not help the accountable care initiative generate savings, according to a new analysis from the Center for...

House Reps Want to Extend MSSP Track 1 ACO Participation

by Jacqueline LaPointe

Seven House Representatives are calling on CMS to allow successful accountable care organizations (ACOs) in the Medicare Shared Savings Program’s (MSSP) Track 1 to continue in the upside-only financial risk track for a third...

71% of MSSP ACOs Likely to Quit Rather Than Assume Downside Risk

by Jacqueline LaPointe

The Medicare Shared Savings Program (MSSP) is requiring the 82 accountable care organizations (ACOs) that started in upside-only financial risk tracks in 2012 or 2013 to take on downside financial risk by 2019. However, the majority of...

Emory Healthcare, Walmart Team Up for an ACO, Bundled Payments

by Jacqueline LaPointe

Atlanta-based Emory Healthcare recently announced the creation of an accountable care organization (ACO) with retail giant Walmart, known as the Accountable Care Plan. Walmart employees at 55 Walmart, Sam’s Club, and Walmart...

MSSP ACOs Fell $2B Short of CBO’s Medicare Spending Estimate

by Jacqueline LaPointe

A new analysis from Avalere showed that Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) failed to reduce Medicare spending as the Congressional Budget Office (CBO) projected in 2010. The CBO estimated...

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