Accountable Care Organizations

AHA: Anti-Kickback Changes Too Narrow to Promote Value-Based Care

by Samantha McGrail

HHS’ Office of Inspector General (OIG) is taking steps toward “much needed reform” of Medicare fraud laws, but more can be done to remove the value-based care barriers presented by...

Accountable Care Organizations Saved Medicare $3.5B, Netting $755M

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the Medicare Shared Savings Program saved CMS approximately $3.52 billion from 2013 to 2017, according to a new analysis from analytic firm Dobson DaVanzo &...

Industry Leaders Support Proposed Changes to ACO Benchmarking

by Jacqueline LaPointe

Fourteen healthcare industry groups, including the American Hospital Association (AHA) and the American Medical Association (AMA), recently backed the campion to Senate legislation that would alter...

Driven By Decline in Medicare Contracts, ACO Participation Dips

by Jacqueline LaPointe

The introduction of Pathways to Success may behind falling accountable care organization (ACO) participation numbers, according to researchers from Leavitt Partners and the Duke-Margolis Center for...

Physician-Led ACOs Saved More Than Hospital ACOs in 2018

by Jacqueline LaPointe

Physician-led accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) produced nearly seven times the savings per beneficiary than hospital-led ACOs, a new analysis...

Advocate Aurora Invests in People, Infrastructure for ACO Success

by Jacqueline LaPointe

Accountable care organization (ACO) success was no stranger to physicians at Advocate Health Care and Aurora Health Care. Now that the two major health systems are combined, the new...

Medicare Shared Savings Program ACOs Saved $739M in 2018

by Jacqueline LaPointe

Accountable care organization (ACOs) in the Medicare Shared Savings Program saved $739.4 million in 2018 after accounting for shared savings and losses that year, according to program data released by...

54% of Physicians Participate in an Accountable Care Organization

by Jacqueline LaPointe

The majority of physicians now participate in an accountable care organization (ACO), the American Medical Association (AMA) recently reported. Overall, 53.8 percent of physicians polled in September...

Reimbursement Adequacy, Timely Data Needed for Risk-Based Payment

by Jacqueline LaPointe

Reimbursement inadequacy, timeliness of data, and access to data are preventing hospitals and health systems from moving to risk-based payment, according to a recent survey from healthcare improvement...

ACO Participation Dipped After Pathways to Success, NAACOS Finds

by Jacqueline LaPointe

The latest accountable care organization (ACO) participation numbers for the Medicare Shared Savings Program (MSSP) raise concerns for the National Association of ACOs (NAACOS). In a recent Health...

ACOs Save More Compared to Medicare Advantage, Report Finds

by Jacqueline LaPointe

The Medicare Shared Savings Program, which governs the majority of Medicare accountable care organizations (ACOs), and Medicare Advantage are gaining in popularity. But the former is saving taxpayers,...

Balancing Specialty and Primary Care Lowers Costs for ACOs

by Jacqueline LaPointe

Accountable care organizations (ACOs) that provided between 40 and 45 percent of office visits through specialists had significantly lower costs compared to ACOs with the lowest and highest specialty...

OIG Identifies What Makes Accountable Care Organizations Successful

by Jacqueline LaPointe

Accountable care organizations (ACOs) have reduced Medicare spending and improved care quality, but some organizations are doing it better than others, the HHS Office of the Inspector General (OIG)...

MSSP Sees Drop in New ACO Participation Under Pathways to Success

by Jacqueline LaPointe

CMS selected 206 accountable care organizations (ACOs) to participate in the Medicare Shared Savings Program (MSSP) under Pathways to Success, including 41 entirely new ACOs and 25 re-entering the...

Downside Financial Risk Adoption Still Low Among ACOs, Study Finds

by Jacqueline LaPointe

The number of accountable care organizations (ACOs) increased roughly fivefold since 2012, but the number of contracts with downside financial risk has remained relatively static, according to a new...

Value-Based Payment Reform Key to Moving Forward with Value

by Jacqueline LaPointe

Value-based payment reform will be the key to lowering healthcare costs and improving care quality, according to health economist Michael Chernew, PhD. At AHIP’s 2019 Institute & Expo in...

3 Strategies to Help Accountable Care Organizations Boost Savings

by Jacqueline LaPointe

Accountable care organizations (ACOs) have come a long way since the Affordable Care Act (ACA). Providers have formed over 1,000 ACOs covering over 32 million patients since the law paved the way for...

Accountable Care Organizations Lower Costs Compared to HMOs, PPOs

by Jacqueline LaPointe

Commercial accountable care organizations (ACOs) in California are outperforming two common provider network arrangements in terms of care quality and total cost of care, according to a recent analysis...

How Downside Risk Will Impact Participation in Pathways to Success

by Jacqueline LaPointe

Providers queued up eagerly to partake in the Medicare Shared Savings Program when the rewards outweighed the risks, but many accountable care organizations exited the program as the balance of risk shifted to their perceived...

Risk-Based Revenue Gains Momentum Among Providers, AMGA Finds

by Jacqueline LaPointe

Risk-based revenue from medical groups and integrated delivery systems (IDNs) accounted for 56 percent of revenues in federal settings and 28 percent of revenues in commercial settings in 2018,...