Noteworthy News

Archive for accountable care organization

 

Medicare Hits Payment Target

Medicare has achieved its goal of tying 30 percent of all Medicare payments to alternative payment models a year early, the Centers for Medicare & Medicaid Services has announced. As of January of 2016, 30 percent of Medicare payments are tied to alternative payment models. In January of 2015, Health and Human Services Secretary Sylvia Mathews Burwell announced the target but said she hoped Medicare could achieve it by 2017. Among the alternative care models to which Medicare payments are now tied are: Medicare Shared Savings Program (MSSP) Pioneer ACOs Next Generation ACOs Comprehensive End Stage Renal Disease (ESRD) Care [&hellip

CMS Proposes Changes in Medicare ACO Benchmarking

The Centers for Medicare & Medicaid Services has proposed a major change in how performance benchmarking is done for participants in its Medicare shared savings program. According to a CMS news release announcing the newly proposed regulation that includes this change, Key proposals include: Recognizing that health cost trends vary in communities across the country by using regional, rather than national, spending growth trends when establishing and updating an ACO’s rebased benchmark. Adjusting an ACO’s rebased benchmark when it enters a second or subsequent agreement period by a percentage (increased over time) of the difference between fee-for-service spending in the [&hellip

Medicare Expands ACO Participation

121 new organizations will be participating in Medicare accountable care organization programs, the Centers for Medicare & Medicaid Services announced this week. 100 new ACOs will join the 150 already participating in the Medicare Shared Savings Program, which rewards organizations that reduce their growth in health care costs while meeting quality performance standards. Of the 250 overall participants, 39 will also participate in a new ACO Investment Model that will provide pre-paid shared savings to encourage the formation of new ACOs in rural and underserved areas. Another 21 ACOs will participate in the Next Generation ACO Model, a new initiative [&hellip

OIG Reveals 2016 Plans

The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) has published its work plan for the 2016 fiscal year. In 2016, the OIG will continue to examine all aspects of HHS endeavor, including Medicare, Medicaid, hospital services, public health activities, and more. In the coming year it will continue a number of hospital-focused projects while also focusing more on health care delivery, health care reform, alternative payment methodologies, and value-based purchasing initiatives. Among the OIG’s planned Medicare projects in 2016 – some of them continued from the past and some of them new, quoted directly from [&hellip

Are Medicare ACOs Living Up to the Hype?

Not yet. At least that’s the conclusion to be drawn based on a report recently released by the Centers for Medicare & Medicaid Services (CMS). According to a CMS fact sheet, …the 20 ACOs [accountable care organizations]in the Pioneer ACO Model and 333 Medicare Shared Shavings Program ACOs generated more than $411 million in total savings in 2014, which includes all ACOs’ savings and losses. At the same time, 97 ACOs qualified for shared savings payments of more than $422 million by meeting quality standards and their savings threshold. The results also show that ACOs with more experience in the [&hellip

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