Noteworthy News

Archive for accountable care organization

 

Serving High-Need, High-Cost Medicare Patients

With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such [&hellip

Urban Hospitals in ACOS Better at Reducing Some Readmissions Rates

A new study has found that hospitals located in metropolitan areas that participate in accountable care organizations are doing a better job than other hospitals of reducing 30-day readmissions rates for Medicare patients who originally were discharged into skilled nursing facilities. It appears this improved performance can be attributed to two things: better discharge planning and better coordination with the skilled nursing facilities. To learn more go here to see the study “ACO-Affiliated Hospitals Reduced Rehospitalizations from Skilled Nursing Facilities Faster Than Other Hospitals.”

ACOs Serving High Proportions of Racial and Ethnic Minorities Lag in Quality Performance

Accountable care organizations that serve large numbers of minority patients score lower on Medicare quality measures than other ACOs, a new study has found. According to the study, ACOs serving larger numbers of minority patients perform worse than other ACOs on 25 of 44 Medicare performance measures – and that performance does not improve over time. The study also pointed out that the minority patients served by ACOs are generally poorer and sicker than other ACO participants. These are the very patients typically served in especially large numbers by urban safety-net hospitals. Learn more about these and other findings in [&hellip

Feds Launch Medicare-Medicaid ACO Model

The Center for Medicare and Medicaid Innovation has announced a new Medicare-Medicaid Accountable Care Organization Model that it says …is focused on improving quality of care and reducing costs for Medicare-Medicaid enrollees. The MMACO Model builds on the Medicare Shared Savings Program (Shared Savings Program), in which groups of providers take on accountability for the Medicare costs and quality of care for Medicare patients. Through the Model, CMS will partner with interested states to offer new and existing Shared Savings Program ACOs the opportunity to take on accountability for the Medicaid costs for their assigned Medicare-Medicaid enrollees. In this new [&hellip

Medicaid Supplemental Payments Set to Evolve

New health care delivery and reimbursement systems and new federal regulations will result in changes in how states deploy their Medicaid resources through supplemental payments in the coming years. A new Commonwealth Fund report describes the kinds of supplemental Medicaid payments states currently make to hospitals – such as disproportionate share and upper payment limit payments – and notes the differing degree to which individual states use such supplemental payments. It also describes how those supplemental payments may be restructured in the coming years to foster greater use of value-based purchasing and to reward achieving state-created quality goals through new [&hellip

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