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

Accountable Care Organizations

61% of Next Generation ACOs Earned Shared Savings in 2016

October 17, 2017 - 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, while just seven organizations will repay the federal agency for shared losses. The Next Generation ACO initiative builds on the Medicare Shared Savings...


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ACOs Plan to Move to Downside Financial Risk, Capitation Contracts

by Jacqueline Belliveau

Accountable care organizations (ACOs) are planning to enter downside financial risk arrangements, with 47 percent planning on entering a shared savings and losses contract and 38 percent pursuing capitation, uncovered a recent survey of 240 ACOs...

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...

Cost Savings Unclear for Medicaid Alternative Payment Models

by Jacqueline Belliveau

Alongside Medicare and private payers, states are making the switch to value-based reimbursement, but states and independent researchers have yet to demonstrate the impact of Medicaid alternative payment models on healthcare costs and patient...

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...

Understanding the Top 10 Terms of Value-Based Purchasing

by Jacqueline Belliveau

Whether providers favor it or not, the healthcare industry is inevitability moving to value-based purchasing. CMS reported in 2016 that Medicare already linked 30 percent of traditional fee-for-service payments to value-based purchasing models...

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...

AHA to IRS: Foster Hospital Participation in Commercial ACOs

by Jacqueline Belliveau

The American Hospital Association (AHA) recently called on leaders from the Department of Treasury and IRS to issue formal guidance that would permit non-profit hospitals to participate in commercial accountable care organizations (ACOs) without...

Incorporating Population Health in Next Gen of Bundled Payments

by Jacqueline Belliveau

The next generation of bundled payments should focus on population health management, researchers recently argued in a Journal of the American Medical Association report. Bundled payment models can align with population health management by extending...

NAACOS: Mandatory Bundled Payments Impede ACO Financial Success

by Jacqueline Belliveau

The National Association of ACOs (NAACOS) recently urged CMS to indefinitely suspend upcoming mandatory Medicare bundled payment models until the federal agency resolves financial conflicts between the episodic arrangements and accountable care...

CMS Reopens Next Generation ACO Application Request Portal

by Jacqueline Belliveau

Providers interested in joining the Next Generation Accountable Care Organization (ACO) model in 2018 can now access the Request for Applications and Letter of Intent on the program’s portal, according to a recent CMS announcement. The...

FFS, Risk-Based Medicaid ACO Programs Similarly Reduce Costs

by Jacqueline Belliveau

In a comparison of two state Medicaid Accountable Care Organization (ACO) programs, researchers in a JAMA Internal Medicine study found that Oregon’s global capitation ACO model produced similar healthcare savings and care quality improvements...

2012 MSSP ACOs Decreased Post-Acute Care Spending by 9%

by Jacqueline Belliveau

A new JAMA Internal Medicine study showed that Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) established in 2012 decreased post-acute care spending by a 9 percent differential reduction by 2014 without compromising...

CMS Reopens 2018 Next Generation ACO Model Applications

by Jacqueline Belliveau

Providers interested in participating in the Next Generation Accountable Care Organization (ACO) model in 2018 can now submit a letter of intent to CMS, according to the alternative payment model’s webpage. The Next Generation ACO model...

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