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Archive for accountable care organization


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

MedPAC Hints at Shared Risk for Medicare ACOs

The independent agency that advises Congress on Medicare payment issues is interested in seeing Medicare accountable care organizations (ACOs) share the financial risk associated with serving their members. At a recent public meeting, members of the Medicare Payment Advisory Commission (MedPAC) noted that the first round of Medicare ACOs share in the savings they help generate while serving their members.  An appropriate next step, some MedPAC members maintained, would be for those ACOs to share the financial risks associated with failing to produce such savings. Currently, ACOs begin with a three-year cycle of no risk but a share of savings.  [&hellip

An Urban Safety-Net ACO

In the Minneapolis-St. Paul area, ten federally qualified health centers (FQHCs) joined forces to create an accountable care organization (ACO) as part of a Medicaid demonstration program.  Together, the FQHCs assumed full responsibility for the medical lives of a defined population. Read about how the FQHCs came together, what they did, and the results they produced in this Commonwealth Fund case study

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