Complimentary from the publisher

Complimentary from the publishers of Accountable Care News August 2021

"An ACO is a total cost-of-care entity. It allows the ACO to work with providers to save costs. Many have been in the model for a very long time and have had savings. If you think about the next step, direct contracting is the next step. Next generation ACOs are now going to direct contracting because of the ability to do so much more than in the Medicare Shared Savings Program. MSSP can't change what you pay providers. In direct contracting, you can change what you pay your underlying providers."
- Aisha Pittman, Vice President of Policy, Premier

MSSP ACOs make up 19% of Medicare beneficiaries according to January CMS enrollment data, with managed Medicare taking up most of the pie at 47% and traditional fee-for-service at 31%; other ACOs and ACO-like models account for 3% of Medicare beneficiaries.

Source: Skilled Nursing News, August 8, 2021.

	Milliman: 5 Key Drivers of Savings in MSSP ACOs 1. An ACO’s benchmark year 3 (BY3) regional efficiency factor (defined as the ACO’s BY3 expenditures divided by the risk-adjusted expenditures in its region) 2. Having a benchmark significantly above costs in benchmark year 3 (BY3), the most recent benchmark year 3. ACOs that selected tracks with downside risk 4. ACOs with few specialists and hospitals on their participant lists 5. Higher rates of primary care evaluation and management (E&M) visits and lower rates of unplanned inpatient hospital admissions Notes: From an article entitled, "What predictive analytics can tell us about key drivers of MSSP results: 2021 update," by Cory Gusland, Robbie Richards, Mackenzie Egan, and Anders Larson. The authors analyzed data from the 2019 performance year for ACOs in the Pathways to Success model (Pathways), referred to by CMS as “2019A.” Source: Milliman, August 4, 2021
	check out more lists on healthsprocket. "What's on your list?"

How cutting off subsidy payments to insurance companies would affect Obamacare

The future of accountable care organizations and Medicare’s other payment models

The Affordable Care Act attempted to improve the value of health spending by testing alternative payment models (APMs) in the Medicare program, emphasizing accountable care organizations. AAEI’s James C. Capretta and Michael E. Chernew of Harvard Medical School discuss the path forward for APMs and how the Medicare Payment Advisory Commission may approach the challenges.

Check out HealthshareTV, the home for health care videos

A New Elephant is in the ACO Waiting Room: It is Following the Money
Salient Healthcare via Medium, August 18, 2021

ACO Participation May Keep SNFs ‘In the Game’
Skilled Nursing News, August 8, 2021

What predictive analytics can tell us about key drivers of MSSP results: 2021
Milliman, August 4, 2021

ACO leaders support new bill to boost participation in value-based payment
Healthcare Finance Management Association, July 26, 2021

3 Strategies To Push ACO Savings Beyond Coordination of Care Limits
Managed Healthcare Executive, July 25, 2021

Vermont Proposes Risk-Bearing, State-Run Medicaid Managed Care Entity
Health Management Associates Blog, July 22, 2021

New bill seeks to reverse slide in ACO participation with more shared savings
FierceHealthcare, July 20, 2021

Providers, payers see direct contracting's capitation as an important move
Healthcare Finance, July 20, 2021

The Impact of the MSSP on utilization of mental health & substance use services
Health Care Management Review, abstract only, July 26, 2021

The effect of participation in ACO on EHI exchange practices in U.S. hospitals
Journal of Community Hospital Internal Medicine Perspectives, June 21, 2021

Organizational Capacity of Hospitals Co-Participating in ACOs & Bundled Payments
American Journal of Medical Quality, abstract only, July 21, 2021

DataGen & Sage Report Details Providers’ Plans for Accountable Care Innovation
Washington DC Watch: CMS Issues Final Rule for 2022 IPPS, Updates ACO Regulations; Radiation Oncologists Descend Digitally on DC, Urge Fixes to VBP Model; NAACOS ‘Pleased’ With CMS’s Proposed 2022 Medicare Physician Fee Schedule
Market Reports: Report Sees Interoperability, Integration Driving Population Health Management Market Innovation; Report Tallies $7B Global VBC Market by 2027
Surveys & Trends: Report Scores US Poorly on Access, Outcomes, Equity – 11th of 11 Countries Studied; Study: ‘Social, Environmental Factors Improve CV Disease Machine Learning; Lux Sees Wearable Biosensor Market Booming.


	Follow Health Policy Publishing:

Subscribe to the Bulletin | Promotional Opportunities