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Top MSSP ACOs Miss the Mark on Shared Savings

May 2, 2018 BY Alanna Moriarty

Top MSSP ACOs Miss the Mark on Shared Savings

According to a new Avalere study, Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) generated savings significantly lower than estimates made by the Congressional Budget Office (CBO) in 2010 when the program first launched. 

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How to Get the Most Value from Bundled Payments

April 24, 2018 BY Alanna Moriarty

How to Get the Most Value from Bundled Payments

The Centers for Medicare and Medicaid Services (CMS) first announced participants for the Bundled Payments for Care Improvement (BPCI) program in January 2013. This past January, CMS announced the implementation of Bundled Payments for Care Improvement Advanced, running from October 2018 through December 2023 and test bundled payments for 32 clinical episodes. Like many CMS programs, BPCI is intended to improve care coordination and clinical outcomes while reducing care costs and unnecessary treatments. 

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Can an ACO Benefit Independent Physicians?

February 21, 2018 BY Alanna Moriarty

Can an ACO Benefit Independent Physicians?

The Congressional budget deal passed earlier this month includes changes to the Medicare Shared Savings Program (MSSP), impacting ACOs participating in the initiative. One of the most prominent changes to the MSSP is the establishment of the ACO Beneficiary Incentive Program, which allows ACOs to pay patients up to $20 for making appointments with their primary care physician—much like the existing Coordinated Care Reward Program. The Beneficiary Incentive Program will also enable beneficiaries to select an ACO-affiliated physician as their primary care provider. Industry experts hope these changes will encourage beneficiaries to be more proactive and engaged in their own care.

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Top Hospitals by Outpatient Medicare Claims

January 3, 2018 BY Alanna Moriarty

Top Hospitals by Outpatient Medicare Claims

Throughout 2017 hospitals and care providers found themselves competing with outpatient care centers. In addition to nearly 8,700 ambulatory surgery centers (ASCs) in the U.S., hospitals must also compete with over 10,800 urgent care clinics and more than 2,500 retail clinics. Patients are continually seeking care that is both convenient and cost-effective, leading to the rise of these outpatient facilities.

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America’s Essential Hospitals Plagued by Healthcare Cuts

December 19, 2017 BY Alanna Moriarty

America’s Essential Hospitals Plagued by Healthcare Cuts

Federal indecision continues to hinder hospitals and healthcare facilities—particularly those serving the most vulnerable patient populations. For members of America’s Essential Hospitals (AEH), the debates over healthcare reform and program funding could mean decreased access for millions of patients. On Dec. 18, the Centers for Medicare and Medicaid Services (CMS) announced the end of Designated State Health Programs (DSHP) funding, which facilitated healthcare delivery reform. Eliminating programs like this not only impacts insurance coverage and care quality but also restricts the kinds of patients a hospital can serve.

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