Accountable Care Organizations

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...

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...

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,...

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)...

A Holistic View of the Patient Enables Risk-Based ACO Success

by Jacqueline LaPointe

Giving providers a holistic view of the patient resulted in accountable care organization (ACO) success for a risk-based organization in southern Florida, which earned a place on the list of ACOs...

Orgs Push for MSSP Track 1 Extension for Non-Risk-Bearing ACOs

by Jacqueline LaPointe

Six healthcare industry groups are urging CMS to extend participation in the Medicare Shared Savings Program (MSSP) Track 1 beyond two agreement periods to allow accountable care organizations (ACOs)...

MSSP ACOs Save More By Spending Less on Inpatient, Post-Acute Care

by Jacqueline LaPointe

Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) have shifted their spending to physician services and away from inpatient and skilled nursing facility care, according to a...

CMS Welcomes 58 Next Generation ACO Model Participants in 2018

by Jacqueline LaPointe

In 2018, the Next Generation ACO model will have a total of 58 participating accountable care organizations (ACOs), up from 45 organizations the previous year, CMS recently announced on the...

AMGA: Align Medicare Advantage, APMs to Promote Value-Based Care

by Jacqueline LaPointe

If CMS moves forward with relaxing Medicare Advantage benefit requirements, then the federal agency should offer the same flexibilities to providers and beneficiaries in Medicare Part B alternative...

Risk-Averse MSSP ACOs Missed $966M By Not Assuming Downside Risk

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the non-risk bearing track of the Medicare Shared Savings Program (MSSP) could have boosted their bottom lines by an additional $966 million in net payments in...

MSSP Accountable Care Organizations Moving to Risk in 2018

by Jacqueline LaPointe

According to a new fact sheet from CMS, the Medicare Shared Savings Program (MSSP) will see some fresh faces in 2018, as well as more accountable care organizations (ACOs) entering downside financial...

Vermont ACO Receives $620M to Lead Healthcare Reform Efforts

by Jacqueline LaPointe

Vermont’s healthcare reform group, Green Mountain Care Board, recently approved a budget of $620 million for OneCare Vermont, an accountable care organization (ACO) working with Medicare,...

New Reporting, Shared Losses Rules for MSSP ACOs in Disaster Areas

by Jacqueline LaPointe

In a new interim final rule, CMS modified quality reporting and shared losses policies for Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) affected by recent natural...

Stakeholders Back Standard ACO Measures for Commercial Orgs in CA

by Jacqueline LaPointe

The Integrated Healthcare Association (IHA) and Pacific Business Group on Health (PBGH) recently embarked on a joint mission to standardize accountable care organization (ACO) measures for quality and...

ACO, Bundled Payments Alignment Key to Success for Both Models

by Jacqueline LaPointe

CMS should align accountable care organizations (ACOs) and bundled payments by creating a blended accountability structure that allows organizations to participate in both alternative payment models...

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

by Jacqueline LaPointe

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...

For Ongoing ACO Shared Savings, Look Outside Inpatient, Primary Care

by Jacqueline LaPointe

Seven years have passed since the Affordable Care Act catalyzed the idea of volume over value in the healthcare industry, paving the way for accountable care organizations (ACOs) to accrue shared shavings while focusing on population...

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

by Jacqueline LaPointe

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...

Collaboration Key to Independent Physicians in Value-Based Care

by Kyle Murphy, PhD

At first glance, value-based care models appear to work against independent physicians. The risk-based arrangement requires a coordination of services across care continuum — primarily between...

MSSP ACOs Improve Care Quality, Struggle to Realize Savings

by Jacqueline LaPointe

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...