Complimentary from the publisher

Complimentary from the publishers of Accountable Care News September 2020

"When ACO leaders use data and analytics to understand care at the episode level, they gain visibility into which specialists provide highly targeted, efficient and effective care. It's optimal that all stakeholders – PCPs, specialists and payers – have access to transparent analytics through a shared platform. That way, everyone understands the drivers behind the best care choices. High-risk patients especially benefit from working with the right specialists, because those relationships allow them to get needed care and reduce the likelihood of costly and adverse events."
- Swati Abbott, CEO, Blue Health Intelligence.

The Medicare Shared Savings Program, the Accountable Care Organization model that served 11.2 million seniors in 2019, "saved Medicare $2.6 billion last year," NAACOS says in a statement, "and saved $1.2 billion last year after accounting for shared savings bonuses and collecting shared loss payments."

Source: Accountable Care News, Volume 11 Number 9, September 2020, News @ Deadline: "NAACOS: CMS Data Says ACOs ‘Saved Medicare $2.6B in 2019’."

	6 Proposed Quality Measures in CMS' New APM Performance Pathways (APP) Model for ACOs or Other APMs 1. CAHPS for MIPS survey results (a patient experience measure) 2. Diabetes: Hemoglobin A1c (HbA1c) Poor Control (an existing measure of chronic disease management) 3. Preventive Care and Screening: Screening for Depression and Follow-up Plan (an existing measure of chronic disease management) 4. Controlling High Blood Pressure (an existing measure of chronic disease management) 5. Hospital-Wide, 30-day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Eligible Clinician Groups (a claims-based population health measure) 6. Risk Standardized, All-Cause Unplanned Admissions for Multiple Chronic Conditions for ACOs (a claims-based population health measure). Notes: The APP model proposes to reduce the number of quality measures for ACOs in 2021 from 23 to 6. APM denotes an Alternative Payment Model; APP denotes APM Performance Pathways; MIPS denotes the Merit-based Incentive Payment System. CAHPS is the Consumer Assessment of Healthcare Providers and Systems, a program of the Agency for Healthcare Research and Quality. Source: "2021 Quality Payment Program Proposed Rule Overview Fact Sheet," U.S. Centers for Medicare and Medicaid Services
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NAACOS Leaders Warn ACOs May Back Out of APM Participation Over Thresholds
Healthcare Innovation, September 17, 2020

10 ACOs with the most shared savings in 2019
Becker's Hospital Review, September 15, 2020

Why Patient Identity Management Is Key To ACO Success, COVID Response
Health IT Outcomes, September 14, 2020

The Case for ACOs During COVID-19
Privia Health Blog, September 2, 2020

Exploring Best Practices in Serious Illness Care for Medicare Advantage & ACOs
The Playbook, September 2, 2020

3 States’ Efforts to Use AC to Improve Oral Health Services in Medicaid
National Academy for State Health Policy (NASHP), August 24, 2020

Cleveland Clinic and Aetna form Accountable Care Organization
Healthcare Finance, August 19, 2020

Health Care Leader Perspectives on State–Sponsored AC for Public Employees
American Journal of Accountable Care, abstract only, September 16, 2020

Medicare Accountable Care Organizations Reduce Spending on Surgery
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News @ Deadline: NAACOS: CMS Data Says ACOs 'Saved Medicare $2.6B in 2019'
Surveys & Trends: Research Findings: 'Not All Hospitals Set Up For Success as ACO'
Washington DC Watch: NAACOS Applauds Rural APM Rules
Thought Leaders' Corner: Few ACOs have explored the possibilities of engaging specialists in cost control, even though specialists drive the major portion of patient spending, including admissions. What actions should ACOs be taking to use the leverage they have with specialists to lower costs, and how can these activities achieve better choices for patients?
Movers & Shakers: LexisNexis' Healthcare Business Welcomes Sultan as VP Strategy
Industry News with briefs regarding Change Healthcare and LexisNexis Risk Solutions
Catching Up With Daniel Cidon


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