Noteworthy News

Archive for accountable care organization

 

State Uses Innovation Funding to Improve Care for Urban Poor

New York’s Medicaid program is taking advantage of federal innovation money to explore new approaches to serving low-income urban Medicaid patients. With the help of Delivery System Reform Incentive Payments (DSRIP), special Medicaid funding from the federal government, caregivers serving Medicaid patients are organizing into accountable care organizations (ACOs) in New York City. Under the experiment, doctors and hospitals join together to serve populations of Medicaid patients. While the doctors are currently paid on a fee-for-service basis, the program’s goal is to move them toward outcomes-based reimbursement, with bonuses paid to providers who achieve specific goals for improving the health [&hellip

Medicare Unveils New ACO

The federal Center for Medicare and Medicaid Innovation is launching a new accountable care organization (ACO) model through which providers can join together to serve Medicare patients. The “Next Generation ACO” seeks to build on the experience, insight, and feedback gained through the Medicare Shared Savings Program and the Pioneer ACO model and give providers more tools for managing care and resources while also enabling them to take on more financial risk and earn greater financial rewards for doing so successfully. A broader objective is to move Medicare closer to its stated goal of paying most providers based on the [&hellip

ACOs Show Encouraging Signs

Provider groups that just completed their first year in Medicare’s ACO programs are showing encouraging signs of producing health care savings. In all, the Centers for Medicare & Medicaid Services (CMS) reports $380 million in savings for first-year participants.  Nearly half of the ACOs participating  in the Shared Savings Program had lower spending than projected but less than half of those  saved enough to qualify to keep any of their savings – one of the program’s main incentives for participants. Pioneer ACOs, which take greater risks, generated $147 million in savings, with nine of the 23 participating groups spending less [&hellip

Medical Homes Model Showing Potential

The “medical homes” model for providing health care is showing promise as a way of reducing the cost of care, reducing utilization of unnecessary medical services, improving access to care, and improving population health. These are among the findings in a meta-study by the Patient-Centered Primary Care Collaborative.  The study brings together findings from 21 studies published between August of 2012 and last December. Medical homes are a major component of accountable care organizations, which are viewed as another important tool in addressing rising health care costs and improving the quality of care delivered.  Many urban safety-net hospitals are pursuing [&hellip

Concern About Churn

State government and health insurers are worried about a process called “churning” – people moving back and forth between Medicaid and private insurers as their income changes.  With more people now qualified for Medicaid, observers believe that as many as nine million people may move back and forth between Medicaid and private insurance in 2014. In the past, people whose income rose enough to lose their Medicaid eligibility often could not afford private insurance and joined the ranks of the uninsured.  Now, some will be eligible for subsidies that may enable them to purchase health insurance on their own.  People [&hellip

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