All Articles In 'Accountable Care Organizations'
Medicare Physician Sustainable Growth Rate: Repealing SGR
For over a decade, the sustainable growth rate (SGR) has been a source of financial worry for physicians who serve Medicare patients. Medicare’s physician payment rate is based on a composite measure of the cost of [...]
Medicare Payment Reform: Post-Acute Provider Reimbursement
The term “post-acute care” (PAC) covers a range of services patients receive after a hospital stay. Skilled nursing facilities, home health care agencies, long-term care hospitals, and inpatient rehabilitation hospitals all provide post-acute care. PAC providers [...]
Chronic Care Management: CMS Multiple Chronic Conditions Dashboard
Many new care models in both the public and private sector focus on people with chronic diseases, particularly conditions like diabetes, congestive heart failure, and hypertension. The Veterans Health Administration (VHA) Care Coordination/Home Telehealth (CCHT) pilot program [...]
Physician Payment Reform: Preparing for Value-Based Reimbursement
Primary care is shifting to payment based on providing higher quality, lower cost health care. New payment models – such as patient-centered medical homes (PCMH) – replace or supplement traditional fee-for-service payments with per-member per-month payments, [...]
Payment Reform Models: Employers Explore Population-Based and Bundled Payment
For the past several years, major payers in U.S. health care have experimented with new payment models that create incentives to control unnecessary health care spending. The traditional fee-for-service model for health insurance does not give [...]
5 Causes of Wasteful Health Care Spending
A painful fact about the U.S. health system is that roughly one third of health costs and spending are wasted. A study in the Journal of the American Medical Association (JAMA) found that wasted health spending [...]
Medicaid Accountable Care Organizations: 10 Core Considerations for Implementing Medicaid ACOs
Leading-edge state Medicaid agencies across the country are exploring the potential of accountable care organizations (ACOs) to drive improvements in quality, delivery, and cost-effectiveness for Medicaid beneficiaries. Seven states in particular – Maine, Massachusetts, Minnesota, New [...]
Accountable Care Organizations: Your Guide to Strategy, Design, and Implementation, by Marc Bard and Mike Nugent
Are you ready to be an Accountable Care Organization (ACO)? Significant new opportunities and challenges face health systems, hospitals, and physician practices as they decide whether to participate in the new Medicare Shared Savings Program and join together to [...]
Hospital Readmissions: Data on Hospital Readmission Rates for Medicare, Medicaid, Privately Insured, and Uninsured Patients
Hospital readmission rates are receiving increasing attention by Medicare, Medicaid, and private health plans. Research shows that a high proportion of hospital readmissions are preventable. Most hospital payment methods, most notably the Medicare Part A inpatient [...]
Accountable Care Organizations: Primer on ACOs and Medicare Shared Savings Program
The Accountable Care Organization (ACO) model is a new Medicare option for physicians, hospitals, and other providers to share in cost-savings. ACOs represent a dramatic change in Medicare policy and an opportunity to transform care delivery [...]
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