Complimentary from the publisher

Complimentary from the publishers of Accountable Care News June 2019

“A lot of us have grown used to having up to six years with no downside risk. In Pathways [the Medicare Shared Savings “Pathways to Success Program”] they still have at least a year or two with no downside risk. It could be hard for the new entrants. They're going to have to really prepare much more than in the past. They're going to have to take it a lot more seriously.”
- Lynn Barr, CEO and founder of Caravan Health.

Regarding commercial revenue from 2015 to 2018, fee-for-service (FFS) payments decreased from 78% to 72% of revenue, and ACO payments increased from 12% to 16%, “with most of the growth coming from upside risk-only ACOs."

Excerpted from: Accountable Care News, Volume 10 Number 6, June 2019, "AMGA Survey Shows Increased Reliance on Risk-Based Revenue."

How cutting off subsidy payments to insurance companies would affect Obamacare

How to Determine Your ACO’s Readiness to Move Toward Risk

As provider organizations prepare for Pathways to Success and determine their best approaches for aligning with CMS’s accelerated risk path, ACO’s have important decisions to make in order to ensure their success under CMS’s value-based initiatives, including how to: determine the right performance track and when to select it; find the right population health management solutions; and assess the overall health of a covered patient population and identify high-risk, high cost members and associated care gaps

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	Commonwealth Fund: ACO Use of Postdischarge Home Visits for Complex Patients 1. Among Medicaid ACOs: 86.7% 2. Among Medicare ACOs: 82.0% 3. Among Commercial ACOs: 79.6% 4. ACO's with risk-bearing payment arrangements: over 50% 5. ACO's without risk-bearing contracts: 30.2% 6. ACO physician practices: 25.7% 7. Non-ACO physician practices: 18.8% Notes: based on a study reported in Health Affairs, "‘Eyes In The Home’: ACOs Use Home Visits To Improve Care Management, Identify Needs, And Reduce Hospital Use," June 2019 Source: Commonwealth Fund, June 4, 2019

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