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

Accountable Care Organizations

Provider Engagement Key to Accountable Care Organization Success

by Jacqueline Belliveau

Accountable care organizations (ACOs) leaders may need to boost healthcare provider engagement to foster value-based care success, a recent study in the American Journal of Accountable Care indicates. In a case study at the Johns Hopkins Medicine...

House Reps Introduce Medicare ACO Improvement Legislation

by Jacqueline Belliveau

House representatives Diane Black (R-TN) and Peter Welch (D-VT) introduced a bill last week that would change the rules for Medicare accountable care organizations (ACOs). The ACO Improvement Act of 2016 contains reforms for Medicare Shared Savings...

Challenges, Successes of First-Year Shared Savings ACOs

by Jacqueline Belliveau

Participants in the Medicare Shared Savings Program (MSSP) already familiar with physician practice transformation were more likely to earn shared savings payments, which should lead the Centers for Medicare & Medicaid Services to focus on...

How Pioneer ACOs Earn Shared Savings, Improve Care Quality

by Jacqueline Belliveau

Massachusetts-based Atrius Health successfully managed several care quality improvements over the previous year and earned both the recognition of CMS and a portion of shared savings as a participant in the Pioneer ACO Model program. In August,...

Next Generation Model Methodology May Boost MSSP ACO Success

by Jacqueline Belliveau

CMS should use a modified Next Generation model benchmark methodology to calculate healthcare cost thresholds to ensure all accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) have an equal opportunity to earn...

CMS: Medicare Accountable Care Organizations Saved Over $466M

by Jacqueline Belliveau

Medicare accountable care organizations (ACOs) saved more than $466 million in 2015, with 125 ACOs qualifying for shared savings payments under the value-based care model, CMS reported in an announcement earlier this week. “The coordinated,...

How CMS Would Reimburse ACOs for Value-Based Care under MIPS

by Jacqueline Belliveau

With a final rule on implementing MACRA coming in the next couple of months, some accountable care organizations (ACOs) have started to analyze new value-based reimbursement structures under the proposed rule. While only a couple of Medicare...

Non-ACO Hospitals Outperform ACOs in Value-Based Care Programs

by Jacqueline Belliveau

To usher in the age of value-based care, CMS has implemented several value-based care programs and introduced various alternative payment models, such as accountable care organizations (ACO). These programs all have a common goal: raise care...

Medicare ACOs Reduce Healthcare Spending On Complex Patients

by Jacqueline Belliveau

While one of the primary goals of joining an accountable care organization (ACO) is to coordinate care in effort to reduce healthcare spending, many Medicare ACO participants have seen early benefits from the alternative payment model. According...

The Future of Accountable Care Organizations Involves Risk

by Jacqueline Belliveau

As many healthcare providers know, participating in a value-based care program, such as an accountable care organization, is about more than just tying payment to quality.  It involves shouldering financial risk as a way to motivate clinicians...

Characteristics of Successful Accountable Care Organizations

by Jacqueline Belliveau

As the number of accountable care organizations (ACO) continues to grow, many healthcare providers are all too familiar with the alternative payment model’s overarching goals of improving care quality, advancing population health, and reducing...

How to Address Challenges of Alternative Payment Models

by Jacqueline Belliveau

As the healthcare industry moves towards value-based care, more providers are choosing alternative payment models to facilitate the transition. CAPG, a trade association of accountable physician organizations, has published a guide of alternative...

OIG: CMS Lacked Good Management Policies for Pioneer ACO Model

by Jacqueline Belliveau

The Pioneer Accountable Care Organization (ACO) program faced a number of management and leadership challenges during its early days, according to a report from the Office of the Inspector General (OIG).  The report indicates CMS faced several...

Medicare Shared Savings Program Gets New Cost Calculations

by Jacqueline Belliveau

The Centers for Medicare and Medicaid Services (CMS) has recently finalized a rule that will change the methodology for calculating costs under Medicare Shared Saving Program, the federal agency announced. MSSP accountable care organizations...

AHA: Commercial ACO Tax Ruling Impedes Value-Based Care Models

by Jacqueline Belliveau

By stripping commercial accountable care organizations (ACOs) of their charitable tax exempt status, the IRS could be threatening the future of value-based care and care coordination, according to the American Hospital Association (AHA). In a...

CMS Allows Some ACOs to Join New Value-Based Care Model

by Jacqueline Belliveau

CMS has expanded the eligibility requirements in the Comprehensive Primary Care Plus (CPC+) model to include primary care physicians in certain Medicare accountable care organizations (ACOs), according to an updated fact sheet. Up to 1,500 primary...

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...

Post-Acute Care Can Help Accountable Care Organizations Save

by Clay Ackerly, MD

As the Center for Medicare and Medicaid Innovation (CMMI) continues to deploy new programs, evidence of the impact of existing models continues to trickle in. One consistent theme: the importance of, and opportunity presented by, improvements...

How MACRA, MIPS Will Impact Critical Access Hospitals, FQHCs

by Catherine Sampson

MACRA means different things to various types of healthcare providers, such as critical access hospitals, rural health clinics and Federally Qualified Health Centers. Although the new MACRA framework provides multiple paths to success with various...

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....

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