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

Medicare Shared Savings Program

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

June 16, 2017 - 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 new American Journal of Accountable Care study stated. Hackensack Physician-Hospital Alliance ACO, LLC (Hackensack Alliance ACO) increased healthcare...


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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...

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 Releases MSSP Track 1+ Model Risk Structures, Eligibility

by Jacqueline Belliveau

In a new Medicare Shared Savings Program (MSSP) Track 1+ fact sheet, CMS clarified model details for 2018 to 2020 participation, including maximum shared savings and losses rates, risk assignments, and eligibility requirements. CMS announced...

What is the Medicare Shared Savings Program Track 1+ Model?

by Jacqueline Belliveau

As the Quality Payment Program links more Medicare payments to value-based reimbursement, a new Medicare Shared Savings Program (MSSP) track will allow eligible clinicians to qualify for additional incentive payments in the program’s Advanced...

How Palliative Care Can Maximize Value-Based Reimbursement

by Jacqueline Belliveau

Providers can boost value-based reimbursement success by incorporating early palliative care into routine cancer care delivery, a new study in the American Journal of Managed Care indicated. Researchers at the Center to Advance Palliative Care...

61% of ACO Contracts Only Include Upside Financial Risk

by Jacqueline Belliveau

A recent Leavitt Partners study showed that 61 percent of accountable care organization (ACO) contracts are upside risk-only, indicating that ACOs may be risk-adverse or are still in the experimental stage with financial risk. Even though ACOs...

Premier Medicare ACOs Outperform Peers in Cost, Quality By 2:1

by Jacqueline Belliveau

Medicare accountable care organizations (ACOs) that are part of Premier Inc.’s Population Health Management Collaborative (PHMC) outperformed other Medicare Shared Savings Program (MSSP) and Pioneer ACOs in earning shared savings and improving...

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...

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,...

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...

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...

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...

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...

Top 5 Facts to Know about MACRA Alternative Payment Models

by Catherine Sampson

CMS recently proposed a rule that would put last year's MACRA's legislation into action. The proposal introduces several significant changes to the way providers will attest to quality improvements and technology use, but also includes...

IRS: Commercial ACO Can’t Claim Charitable Tax Exemptions

by Catherine Sampson

An unnamed accountable care organization (ACO) will not be able to claim charitable tax exempt status since its role centered on facilitation instead of the provision of care, the IRS said in a determination letter this month. The ACO, which...

NAACOS Comments on Accountable Care Organizations Benchmarks

by Vera Gruessner

Last month, the National Association of ACOs (NAACOS) submitted comments for the Health Care Payment Learning & Action Network (LAN) Financial Benchmarking Draft White Paper. NAACOS takes on the largest portion of accountable care organizations...

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