By Stacy Tyman – CMS final rule on changes to the Medicare Shared Savings Program requirements acknowledged that there were some ACOs who did not successfully report Quality Measures Data for their members in 2015.
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By Jeremy Guttman – Healthcare leaders who were once optimistic about value-based reimbursement models are becoming doubtful after seeing the performance of several programs. ACOs are achieving modest gains.
Affordable Care Act Accountable Care Organization initiatives put patients at the center of their care while generating more than $1.29 billion in total Medicare savings since 2012.
By Chad Terhune – In another sign of growing frustration with rising health costs, aerospace giant Boeing Co. has agreed to contract directly for employee benefits with a major health system in Southern California, bypassing the conventional insurance model.
By Sharon Arnold PhD – Much has been written about the importance of finding alternatives to the volume-increasing incentives of traditional fee for service payments and one solution or change will not create an instant results. However, there is a continuum between pure fee for service and pure capitation.
By John Kelly & Jay Sultan – Between the payer consolidations, the long-awaited transition to ICD-10 and the shift toward value-based care, healthcare saw major changes begin to take hold in 2015. Coming off the momentum of the previous year, we can expect even more – especially as providers begin to take on more and more risk.
The Centers for Medicare & Medicaid Services (CMS) announced 121 new participants in Medicare Accountable Care Organization (ACO) initiatives designed to improve the care patients receive in the health care system and lower costs. With this announcement, ACOs now represent 49 states and the District of Columbia.
By Don Michaels PhD – One of the key concepts to rise out of the turbulent past decade in the healthcare industry is the Accountable Care Organization (ACO). In the ACO model, private and government payers offer the opportunity for financial incentives to groups of providers to encourage them to come together voluntarily to deliver high quality while keeping costs down.
By Matt Fisher – The annual OIG Work Plan was published on November 2nd. The Work Plan each year identifies what the Office of the Inspector General of the Department of Health and Human Services will review and provides insight into what the OIG contemplates as risk areas.