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ACO Accountable care organizations

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https://www.readbyqxmd.com/read/29290594/advanced-imaging-utilization-and-cost-savings-among-medicare-shared-savings-program-accountable-care-organizations-an-initial-exploratory-analysis
#1
Andrew B Rosenkrantz, Richard Duszak
INTRODUCTION: The purpose of this study was to explore associations between CT and MRI utilization and cost savings achieved by Medicare Shared Savings Program (MSSP)-participating accountable care organizations (ACOs). METHODS: Summary data were obtained for all MSSP-participating ACOs (n = 214 in 2013; n = 333 in 2014). Multivariable regressions were performed to assess associations of CT and MRI utilization with ACOs' total savings and reaching minimum savings rates to share in Medicare savings...
December 28, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29274632/medicare-program-medicare-shared-savings-program-extreme-and-uncontrollable-circumstances-policies-for-performance-year-2017-interim-final-rule-with-comment-period
#2
(no author information available yet)
This interim final rule with comment period establishes policies for assessing the financial and quality performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) affected by extreme and uncontrollable circumstances during performance year 2017, including the applicable quality reporting period for the performance year. Under the Shared Savings Program, providers of services and suppliers that participate in ACOs continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements...
December 26, 2017: Federal Register
https://www.readbyqxmd.com/read/29231131/impact-of-accountable-care-organizations-on-utilization-care-and-outcomes-a-systematic-review
#3
Brystana G Kaufman, B Steven Spivack, Sally C Stearns, Paula H Song, Emily C O'Brien
Since 2010, more than 900 accountable care organizations (ACOs) have formed payment contracts with public and private insurers in the United States; however, there has not been a systematic evaluation of the evidence studying impacts of ACOs on care and outcomes across payer types. This review evaluates the quality of evidence regarding the association of public and private ACOs with health service use, processes, and outcomes of care. The 42 articles identified studied ACO contracts with Medicare ( N = 24 articles), Medicaid ( N = 5), commercial ( N = 11), and all payers ( N = 2)...
December 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29211623/quality-of-care-improves-for-patients-with-diabetes-in-medicare-shared-savings-accountable-care-organizations-organizational-characteristics-associated-with-performance
#4
Taressa K Fraze, Valerie A Lewis, Emily Tierney, Carrie H Colla
Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes...
December 6, 2017: Population Health Management
https://www.readbyqxmd.com/read/29204975/characteristics-and-disparities-among-primary-care-practices-in-the-united-states
#5
David Michael Levine, Jeffrey A Linder, Bruce E Landon
BACKGROUND: Despite new incentives for US primary care, concerns abound that patient-centered practice capabilities are lagging. OBJECTIVE: Describe the practice structure, patient-centered capabilities, and payment relationships of US primary care practices; identify disparities in practice capabilities. DESIGN: Analysis of the 2015 Medical Organizations Survey (MOS), part of the nationally representative Medical Expenditure Panel Survey (MEPS)...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29200328/medicare-aco-program-savings-not-tied-to-preventable-hospitalizations-or-concentrated-among-high-risk-patients
#6
J Michael McWilliams, Michael E Chernew, Bruce E Landon
It has been widely assumed that better management and coordination of care for chronic conditions and high-risk patients would be the leading mechanisms for achieving savings in accountable care organizations (ACOs), specifically by reducing acute care needs through enhanced outpatient and preventive care. We examined the extent to which changes in spending and hospitalizations for ACO patients in the Medicare Shared Savings Program (MSSP) have been consistent with this expectation. By 2014, participation in the MSSP was associated with significant reductions in total Medicare fee-for-service spending for ACO patients but with proportionately smaller reductions in hospitalizations and some increases in hospitalizations for ambulatory care-sensitive conditions...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#7
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29135767/implementing-accountable-care-organizations-lessons-from-a-qualitative-analysis-of-four-private-sector-organizations
#8
Daniel M Walker, Jennifer L Hefner, Lindsey N Sova, Brian Hilligoss, Paula H Song, Ann Scheck McAlearney
Accountable care organizations (ACOs) are emerging across the healthcare marketplace and now include Medicare, Medicaid, and private sector payers covering more than 24 million lives. However, little is known about the process of organizational change required to achieve cost savings and quality improvements from the ACO model. This study applies the complex innovation implementation framework to understand the challenges and facilitators associated with the ACO implementation process. We conducted four case studies of private sector ACOs, selected to achieve variation in terms of geography and organizational maturity...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29090623/care-transformation-strategies-and-approaches-of-accountable-care-organizations
#9
Valerie A Lewis, Katherine I Tierney, Taressa Fraze, Genevra F Murray
Although accountable care organizations (ACOs) proliferate, little is known about the activities and strategies ACOs are pursuing to meet goals of reducing costs and improving quality. We use semistructured interviews with executives at 16 ACOs to understand ACO approaches. We identified two overarching ACO approaches to changing clinical care: a practice-based transformation approach, working to overhaul care processes and teams from the inside out; and an overlay approach, where ACO activities were centralized and delivered external to physician practices...
October 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29058518/recent-evidence-on-the-inclusion-of-hospice-and-palliative-care-physicians-in-medicare-shared-savings-program-accountable-care-organization-networks
#10
Julia Driessen, Turner West
OBJECTIVE: To document the presence of hospice and palliative physicians in Medicare Shared Savings Program (MSSP) ACOs. BACKGROUND: End-of-life care exhibits extreme variation in quality, cost, and patient experience. This baseline creates opportunities for improvements that would be financially rewarded in the new value-based reimbursement environment, such as the accountable care organization (ACO) model. Little is known about how ACOs have responded to this opportunity by including hospice and palliative providers in their formal provider networks...
October 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29053177/early-effect-of-medicare-shared-savings-program-accountable-care-organization-participation-on-prostate-cancer-care
#11
Tudor Borza, Samuel R Kaufman, Phyllis Yan, Lindsey A Herrel, Amy N Luckenbaugh, David C Miller, Ted A Skolarus, Bruce L Jacobs, John M Hollingsworth, Edward C Norton, Vahakn B Shahinian, Brent K Hollenbeck
BACKGROUND: Accountable care organizations (ACOs) can improve prostate cancer care by decreasing treatment variations (ie, avoidance of treatment in low-value settings). Herein, the authors performed a study to understand the effect of Medicare Shared Savings Program ACOs on prostate cancer care. METHODS: Using a 20% Medicare sample, the authors identified men with newly diagnosed prostate cancer from 2010 through 2013. Rates of treatment, potential overtreatment (ie, treatment in men with a ≥75% chance of 10-year mortality from competing risks), and Medicare payments were measured using regression models...
October 20, 2017: Cancer
https://www.readbyqxmd.com/read/29035338/integrating-medication-therapy-management-mtm-services-provided-by-community-pharmacists-into-a-community-based-accountable-care-organization-aco
#12
Brian Isetts
(1) Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT) infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO)...
October 16, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28984496/spending-carveouts-substantially-improve-the-accuracy-of-performance-measurement-in-shared-savings-arrangements-findings-from-simulation-analysis-of-medicaid-acos
#13
Derek DeLia
Accuracy of spending-based provider performance metrics is limited by random variation and components of spending that are uncontrollable by providers. Such components vary according to the care management focus and operational maturity of each provider group. This study uses data from New Jersey Medicaid accountable care organizations (ACOs) to examine how carving out uncontrollable components of spending affects the accuracy of performance measures in shared savings arrangements. Spending on injury care, custodial care in facilities (CCF), and amounts above $100 000 per patient are used as examples of potentially uncontrollable spending...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28944730/optimization-of-medication-use-at-accountable-care-organizations
#14
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28915166/factors-associated-with-hospital-participation-in-centers-for-medicare-and-medicaid-services-accountable-care-organization-programs
#15
Askar S Chukmaitov, David W Harless, Gloria J Bazzoli, Yangyang Deng
BACKGROUND: In 2012, the Centers for Medicare and Medicaid Services (CMS) initiated the Medicare Shared Savings Program (MSSP) and Pioneer Accountable Care Organization (ACO) programs. Organizations in the MSSP model shared cost savings they generated with CMS, and those in the Pioneer program shared both savings and losses. It is largely unknown what hospital and environmental characteristics are associated with the development of CMS ACOs with one- or two-sided risk models. PURPOSE: The aim of this study was to assess the organizational and environmental characteristics associated with hospital participation in the MSSP and Pioneer ACOs...
September 15, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28885989/the-role-of-health-information-technology-in-advancing-care-management-and-coordination-in-accountable-care-organizations
#16
Frances M Wu, Stephen M Shortell, Thomas G Rundall, Joan R Bloom
BACKGROUND: To be successful, accountable care organizations (ACOs) must effectively manage patient care. Health information technology (HIT) can support care delivery by providing various degrees of coordination. Few studies have examined the role of HIT functionalities or the role of different levels of coordination enabled by HIT on care management processes. PURPOSES: We examine HIT functionalities in ACOs, categorized by the level of coordination they enable in terms of information and work flow, to determine which specific HIT functionalities and levels of coordination are most strongly associated with care management processes...
October 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28885893/does-patient-centered-medical-home-recognition-relate-to-accountable-care-organization-participation
#17
Yi-Ling Lin, Yuan Du, Cristina Gomez, Judith Ortiz
As of April 2015, less than 10% of Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) included Rural Health Clinics (RHCs). In order to understand why RHCs are not participating in this ACO model in greater numbers, this study examined the influence of several factors on ACO participation. Data for this study were collected via a survey distributed during the summers of 2012, 2013, and 2014 to all RHCs in 9 states. This study had a cross-sectional design using survey research. The unit of analysis was the RHC; the total sample size was 178...
September 8, 2017: Population Health Management
https://www.readbyqxmd.com/read/28861654/breast-cancer-screening-for-patients-of-rural-accountable-care-organization-clinics-a-multi-level-analysis-of-barriers-and-facilitators
#18
Hongmei Wang, Abbey Gregg, Fang Qiu, Jungyoon Kim, Baojiang Chen, Neng Wan, Dejun Su, Tzeyu Michaud, Li-Wu Chen
Not all women 50-74 years received biennial mammography and the situation is worse in rural areas. Accountable care organizations (ACO) emphasize coordinated care, use of electronic health system, and preventive quality measures and these practices may improve their patients' breast cancer screening rate. Using medical record data of 8,347 women patients aged 50-74 years from eight rural ACO clinics in Nebraska, this study examined patient-, provider-, and county-level barriers and facilitators for breast cancer screening...
August 31, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28854072/acclimating-to-the-increase-in-statin-use-in-accountable-care-organizations-based-on-changes-in-quality-measures-a-report-from-the-accountable-care-organization-research-network-services-and-education
#19
Leah Bensimon, Genevieve Hale
The Accountable Care Organization Research Network, Services, and Education (ACORN SEED), founded by faculty members at Nova Southeastern University College of Pharmacy, is a group of pharmacists that provides unique pharmacy services to accountable care organizations (ACOs), patient-centered medical homes, and management services organizations to help maximize shared savings and target medication-related issues, while promoting the pharmacy profession and unique learning experiences for pharmacy students within these settings...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28806586/the-new-frontier-of-strategic-alliances-in-health-care-new-partnerships-under-accountable-care-organizations
#20
Valerie A Lewis, Katherine I Tierney, Carrie H Colla, Stephen M Shortell
Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form...
October 2017: Social Science & Medicine
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