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ACOs and Marketplace Competition

12 Responses

1. Hope R. Hetico RN MHA, on January 3, 2014 at 2:36 PM said:

   The PP-ACA and Related Headlines You’ll See in 2014
   [Some Projections for the Future?]

   http://thehealthcareblog.com/blog/2014/01/02/headlines-youll-see-in-2014/

   Can you add any others?

   Hope R. Hetico RN MHA

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2. Amy, on January 3, 2014 at 3:12 PM said:

   Twelve Health Care Predictions for 2014

   Hope – While the Disease Management Care Blog eschewed forecasting for 2013, it has decided to reverse course and inaugurate the 2014 blogging season with a contrarian duodecimal exercise in futurism.

   http://diseasemanagementcareblog.blogspot.com/2014/01/twelve-health-care-predictions-for-2014.html

   Trust all your ME-P readers enjoy the article; and HNY to all.

   Amy

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3. Ann Miller RN MHA, on January 6, 2014 at 7:34 PM said:

   ACA Reactions from Midsized Business Owners and Executives

   * Definitely will not cap part-time hours so workers remain below regulatory requirements for an offer of coverage. – 23%

   * Considering capping part-time hours so workers remain bellow regulatory requirements for an offer of coverage. – 31%

   * Definitely will not suspend hiring – 37%

   * Considering Suspending hiring. – 26%

   * Definitely will not downsize the number of employees as a result of the ACA. – 50%

   * Considering downsizing the number of employees as a result of the ACA. – 25%

   Data Source: ADP Research Institute
   Publication Source: Employee Benefit News, December 2013

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4. Hope R. Hetico RN MHA, on March 5, 2014 at 5:07 PM said:

   ACOs,

   Interested readers may check out this link:

   http://www.kaiserhealthnews.org/Stories/2014/February/21/Medicare-Data-Shows-Wide-Differences-In-ACOs-Patient-Care.aspx?utm_campaign=KHN%3A+Topic-based&utm_source=hs_email&utm_medium=email&utm_content=12107437&_hsenc=p2ANqtz-9GcsZClVXmJC_h1pmk26-4kRHLaB-NIuUfbmLENOieEPQfhG_RXYK76-eOPbcc67z3dnRUlE2xJuXrRWrScvOefiybt9Y-V6-qeex_JMeYV7szZZI&_hsmi=12107437

   Hope R. Hetico RN MHA

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5. Ann Miller RN MHA, on May 8, 2014 at 2:00 PM said:

   Debate ignites over how many ACA enrollees paid premiums
   [90-day grace period could still hurt physician collections]

   Based on industry data collected through April 15, the GOP-led House Energy and Commerce Committee estimates that only 67% of healthcare exchange enrollees have paid their premiums.

   http://medicaleconomics.modernmedicine.com/medical-economics/news/physicians-caught-politics-aca-enrollment-data

   Ann Miller RN MHA

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6. Jeff, on June 7, 2014 at 11:46 PM said:

   ACOs and restricted networks

   In a world where people seek out physicians based on personal recommendations or Yelp-like rating system where personality matters more than skill, a little less choice in smaller networks might be exactly what we need.

   Jeff

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7. Amy, on June 18, 2014 at 6:31 PM said:

   ACO Penetration

   More than two-thirds of the U.S. population now live in localities served by accountable care organizations and more than 40 percent live in areas served by two or more.

   The figures come from a new analysis by the consulting firm Oliver Wyman, that finds the latest round of approvals in January 2014 brings the total of Medicare ACOs to 368, up from 259 a year ago, and the total number of ACOs including commercial and other non-Medicare organizations to 522, up from 320.

   Amy

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8. Henry Loubet, on June 30, 2014 at 5:44 PM said:

   ACOs and Bundled Payments

   In concept, Bundled Payments appear to provide a path to reducing health care costs and improving the quality of care for patients. However, as noble as the concept is, the execution of implementing Bundled Payments is extremely challenging. That being said, it is clear that many hospital systems are testing the waters in the Bundled Payment pool – if only for one or two types of procedures – and the probability is that this experiment will continue on a larger scale over the course of the next five years.

   One of the chief obstacles of adopting a Bundled Payment model is the ability of the provider (e.g., hospital, care facility, etc.) to predict the experience of an average patient within an episode and to understand what causes other patients to require a variation to that typically-required level of care. Providers will need to assume some risk when adopting Bundled Payments, and in order to do so they must have an adequate amount of data to establish the costs on average for a specific episode.

   With the development of Accountable Care Organizations (ACOs), there may be a path to mainstream adoption of Bundled Payment programs. ACOs produce a structure for providers to work together to manage the challenges (i.e., legal and financial) of building an episode of care and bundled payment program. Furthermore, ACOs are intended to assist with perpetuating behavioral changes which includes better use of health resources. These structures may prove to be the successful method in improving clinical outcomes which in turn will make it easier to establish predictable cost models for Bundled Payment programs for specific episodes.

   With all of this in mind, it is probable that Bundled Payments will continue to expand in their acceptance for certain cardio-vascular and orthopedic episodes. These procedures, where there is a predictable level of services for an episode, and lower variation in the care required, may prove to benefit from the Bundled Payment approach. As for chronic condition episodes, this model is yet to appear to be a feasible alternative to the fee-for-service approach.

   Henry Loubet
   [Chief Strategy Officer]
   Keenan

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9. Dr. Symington, on August 14, 2014 at 4:16 PM said:

   The ACA contains a major flaw

   It lacks true accountability for the patients it means to protect.

   Therefore, it’s up to the industry to instill the need for patients to become actively involved in their care. Patient engagement will be a driving force.
   
   Dr. Symington

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10. Amy, on October 8, 2014 at 5:32 PM said:

    More on ACOs

    Around the nation in 2014, over 360 Accountable Care Organizations participate in Medicare, and hundreds more in commercial and Medicaid programs. More than two-thirds of the U.S. population now live in localities served by accountable care organizations and more than 40 percent live in areas served by two or more.

    And, as new ACOs continue to develop around the country, and existing organizations continue to mature, a variety of models and approaches have emerged and evolved, with a growing track record to take stock of. Fifteen Medicare ACOs now participate in Maryland, for example, including six added in 2014.

    MedChi, The Maryland State Medical Society, established a Network Services division to provide business support tailored for private practices, including development and management of physician-led ACOs. MedChi Network Services was awarded three Advance Payment ACOs in Maryland by CMS during 2012 and 2013.

    Amy
    [Baltimore, MD]

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11. Hope R. Hetico RN MHA, on January 7, 2015 at 1:25 PM said:

    10 reasons why healthcare isn’t a free market

    According to M. Goozner, from the home office in Chicago, here are 10 reasons why the healthcare economy would have made free-market evangelist Milton Friedman want to burn his book “Free to Choose.”

    FULL STORY » http://www.modernhealthcare.com/article/20141213/MAGAZINE/312139984?utm_source=AltURL&utm_medium=email&utm_campaign=mostreq

    Hope R. Hetico RN MHA

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12. Editor, on February 15, 2018 at 9:13 PM said:

    Top Ten MSSP ACOs by Attributed Patients

    1. Advocate Physician Partners Accountable Care (IL) 139,617
    2. Delaware Valley ACO (PA, NJ) 123,888
    3. Physicians Accountable Care Solutions (8 States) 115,415
    4. POM ACO (MI) 104,559
    5. UT Southwestern Accountable Care Network (TX) 87,479
    6. Mercy Health ACO (4 States) 82,614
    7. Illinois Health Partners ACO (IL) 81,093
    8. Health Connect Partners (WA, MT, AK) 76,497
    9. Good Help ACO (6 States) 74,386
    10. University of Iowa Health Alliance Accountable Care Organization (IA, IL) 73,192

    Ann Miller RN MHA

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