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Archive for accountable care organization

 

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

A New Approach to Serving High-Cost, High-Need, High-Risk Medicaid Patients

A partnership consisting of a county government, a public hospital, a county-run Medicaid managed care plan, and a federally qualified health center, Hennepin Health is an accountable care organization that seeks to serve high-cost, high-need, high-risk Medicaid patients in the greater Minneapolis area. Hennepin Health targets such individuals – all childless adults who became eligible for Medicaid when the state expanded its Medicaid program in 2011 – with the help of algorithms, identifies those most likely to incur high medical costs. It then offers a blend of social services, preventive care, and other services to address members’ medical conditions while [&hellip

Docs Less Likely to Participate in ACOs in Disadvantaged Communities

A new study has found that physicians who practice in areas with higher proportions of low-income, uninsured, less-educated, disabled, and African-American residents are less likely than others to participate in accountable care organizations. If ACOs ultimately are found to improve health care quality while better managing costs, their benefits might be limited in such communities, thereby exacerbating health care disparities. It also would be disadvantageous to many of the communities served by the nation’s private, non-profit urban safety-net hospitals. To learn more, go here to see the Health Affairs report “Physicians’ Participation In ACOs Is Lower In Places With Vulnerable Populations Than In More [&hellip

Medicare ACOs Showing Promise Among Clinically Vulnerable

A new study has found that Medicare patients with multiple acute or chronic medical conditions who are served by accountable care organizations cost less to serve and visit hospital emergency rooms less frequently. Such patients also had fewer ambulatory care-sensitive hospital admissions and 30-day hospital readmissions. The study, published in JAMA Internal Medicine, traced the reduction in costs to providers making less use of institutional settings when treating their clinically vulnerable patients. To learn more about the study and its potential implications for both taxpayers and the 23 million Americans enrolled in more than 700 ACOs, go here to see a report from [&hellip

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