“It’s not how you start, but how you finish” might be the way some ACOs must navigate a difficult path to success. But for organizations planning a new ACO venture, that rocky path may be avoidable. The early days of ACO development are behind us, and ACO models to take on financial risk are now […]
Unify ACO Quality and Cost Initiatives to Boost Long-term Results
Let’s face it. There’s a pretty low bar to meeting Medicare’s ACO Quality requirements. Most ACOs have achieved acceptable quality performance for Medicare Shared Savings Plans (MSSPs). They have not, however, achieved the savings needed to be successful. ACO supporters point to the “Triple Aim” of achieving higher quality, cost savings and good patient experience […]
ACOs Must Create Learning Environment for Physicians to Be Partners in Change
The idea behind ACOs sounds simple enough: Build a network of primary care physicians, specialists, hospitals and other health care organizations that share risk and responsibility to provide coordinated care for each patient. Medicare or private insurers offer financial incentives to ensure that ACOs provide quality treatment while limiting unnecessary spending. Primary care physicians serve […]
Reluctant Providers Can Benefit from Fresh Approach to ACOs
It’s no secret that CMS wants to move providers away from MIPS and the Fee-for-Service payment system, toward an Alternative Payment Model (APM) like an Accountable Care Organization (ACO). This past January’s announcement of an additional 124 new ACOs implies that we have reached a tipping point, with ACOs becoming more prevalent than standard Fee-for-Service […]
Five Ways Medicare’s Patient Data-Sharing Will Rock Health Care
Medicare came closer to fulfilling its promise of patient data-sharing last week with the announcement of bundled initiatives to connect health care consumers with their health care data. First, the Trump administration announced the launch of myHealthEData, a government-wide initiative designed to permit patients to control their healthcare data and determine how it can be […]
Shared Decision-Making May Be the Next Consumer Health Movement
Consumers are rapidly mobilizing around all aspects of health care—affordability, access to the system and choices about their care. As changes in health insurance shift more and more cost onto consumers, patients want to be involved in decisions that will affect their finances as well as their health. Yet they face a dilemma: The only […]
How Safe is Medicare? What To Know About White House Budget Proposals
Health care providers may be lulled into believing that Medicare budget cuts proposed by the White House last week won’t happen. Media reports have repeatedly emphasized that the budget is simply a policy proposal. Congress alone has the authority to determine spending limits and allocate funds. But labeling this budget—and the Medicare proposals in it—as […]
Don’t Just Check the Box: Capture the Patient’s Story to Define Meaningful Goals of Care
What does Shared Decision-Making between doctor and patient really look like? I spent four decades as a primary care physician, as well as 27 years teaching medical students and residents. Looking back on my treatment of patients, I now question whether my management was driven by what the patient wanted—or by what I wanted for […]
Five Lessons from Big Business on Value-Based Health Care
Last year we predicted that CMS would step back from the complex requirements of its Value-Based Health Care initiative, in favor of reducing provider burdens for quality reporting and reducing regulation, in general. While MACRA MIPS and the move toward financial risk still remain, we correctly anticipated that Medicare would focus its efforts on its […]
What Does #MeToo Have to Do With Value-Based Health Care?
Are we measuring the right things in Value-Based Health Care? That’s the question I am asking myself while reviewing recent efforts by CMS to create better measures of health care value, called Meaningful Measures. Given current, widespread reports of sexual abuse and my recent reading about the dismal state of elder health care, I can’t […]