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

Accountable Care Organization

High-Risk Patient Management Did Not Drive Early ACO Cost Savings

December 13, 2017 - Care coordination and care management strategies focused on high-risk and chronically ill patients did not drive early cost savings among accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP), a recent Health Affairs study uncovered. Researchers from Harvard Medical School found that ACOs that entered the MSSP in 2012 significantly lowered spending on high-risk...


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High-Value Culture, Population Health Programs Key to ACO Success

by Jacqueline Belliveau

Creating a high-value culture, engaging in proactive population health management, and implementing an infrastructure that promotes continuous performance improvement were key characteristics of 11 successful accountable care organizations (ACOs)...

MSSP ACOs Improve Care Quality, Struggle to Realize Savings

by Jacqueline Belliveau

Medicare accountable care organizations (ACOs) found overwhelming success with care quality improvements in 2016, but the organizations were still working on reducing costs, according to a recent analysis published in the Health Affairs blog....

Accountable Care Organizations Cut Medicare Spending by $836M

by Jacqueline Belliveau

Accountable care organizations (ACOs) decreased Medicare spending by $836 million in 2016, new data from CMS revealed. As a result, the organizations from four Medicare ACO programs returned about $70.6 million in healthcare savings to the Medicare...

AMGA to Reps: Pass CHRONIC Care Act to Aid ACOs, Team-Based Care

by Jacqueline Belliveau

AMGA recently pushed House Representatives to pass the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which would particularly support accountable care organizations (ACO) implementing chronic...

61% of Next Generation ACOs Earned Shared Savings in 2016

by Jacqueline Belliveau

The majority of Next Generation Accountable Care Organizations (ACOs) earned shared savings in the first year of the model, recent data from CMS revealed. Eleven of 18 total Next Generation ACOs will receive a shared savings payment from CMS,...

MSSP ACOs Decreased Spending by $1B, Improved Care Quality

by Jacqueline Belliveau

Accountable care organizations (ACOs) participating in the first three years of the Medicare Shared Savings Program (MSSP) reduced Medicare spending, with a net reduction of almost $1 billion, according to a new OIG report. The analysis of 428...

Accountable Care Organization Saves $4.8M With Nutrition Aid

by Jacqueline Belliveau

A case study in American Health & Drug Benefits showed that Advocate Health Care, an accountable care organization in the Chicago area, reduced healthcare costs by $3,800 per patient, or $4.8 million in total, by implementing a nutrition...

Accountable Care Organizations Grow, But Face New Challenges

by Jacqueline Belliveau

Since the Affordable Care Act paved the way for accountable care organizations (ACOs) in 2010, healthcare providers have increasingly turned to the alternative payment model as a way to engage in value-based care across patient populations. In...

MSSP ACOs Missed $886M in Potential Revenue By Avoiding Risk

by Jacqueline Belliveau

Accountable care organizations (ACOs) in Track 1 of the Medicare Shared Savings Program (MSSP) could have received an additional $886 million in net payments in 2015 if the organizations took on downside financial risk and earned the 5 percent...

Core Competencies for Accountable Care Organization Development

by Jacqueline Belliveau

The National Business Group on Health (NBGH) recently identified the core competencies accountable care organizations (ACOs) should have at each stage of its development. The two resources from NBGH on ACO competencies are meant to help employers...

Accountable Care Organizations Continue to Grow With 11% Boost

by Jacqueline Belliveau

The number of accountable care organizations (ACOs) increased with 92 more organizations operating since the first quarter of 2016, reaching a total of 923 ACOs nationwide by the start of 2017, a recent Health Affairs blogpost stated. The Leavitt...

Do Financial Benchmarks Truly Measure ACO Savings, Spending?

by Jacqueline Belliveau

Healthcare stakeholders should not use financial benchmarks developed by CMS to evaluate actual accountable care organization (ACO) savings, three Harvard Medical School experts in a recent Health Affairs blogpost. As Medicare ACOs grow in popularity,...

ACOs Restructure Healthcare Staffing for High-Risk Patients

by Jacqueline Belliveau

To successfully lower healthcare costs while improving care quality, accountable care organizations (ACOs) have restructured their healthcare staffing models to provide additional support to high-risk patients, a recent American Journal of Accountable...

Targeting Skilled Nursing Facility, ESRD Care Saves ACO $15M

by Jacqueline Belliveau

A Medicare Shared Savings Program (MSSP) accountable care organization (ACO) realized over $15 million in healthcare savings between 2014 and 2015 by improving skilled nursing facility utilization and targeting end-stage renal disease care, a...

Detailing ACO Challenges with Risk, MACRA Implementation

by Jacqueline Belliveau

While accountable care organizations (ACOs) are popular and effective ways to implement value-based care, many ACOs are still facing significant challenges with managing risk and healthcare costs as the industry prepares for MACRA implementation....

Mixed Results for MSSP Accountable Care Organization Savings

by Catherine Sampson

According to a report from Leavitt Partners, 42 percent of accountable care organizations (ACO) residing in high-cost markets in the Medicare’s Shared Savings Program (MSSP) earned shared savings, while only 18 percent of organizations...

AHA: MACRA Alternative Payment Model Incentives Need Changing

by Catherine Sampson

The MACRA Alternative Payment Model incentives should be implemented in a way that provides the best opportunity for physicians to become qualifying participants, the American Hospital Association argued in a letter to CMS this week MACRA provides...

Anthem Accountable Care Organizations Save $14.8 Million

by Catherine Sampson

Four medical groups participating in Anthem Blue Cross accountable care organization (ACO) arrangements were able to save a total of $14.8 million from 2013 to 2014 due to improved coordinated care efforts, according to an Anthem press release....

Number of Accountable Care Organizations Continue to Rise

by Catherine Sampson

The number of accountable care organizations (ACOs) continue to increase across the county. Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced 121 new Medicare Accountable Care Organization (ACO) participants. Between...

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