Over the first three years of the Medicare Shared Savings Program (2013-2015), 428 Accountable Care Organizations (ACOs) served 9.7 million beneficiaries. Most of these participating ACOs reduced Medicare spending compared to their benchmarks, resulting in a net spending reduction of nearly $1 billion, according to an August report from the Office of the Inspector General […]
(The following includes excerpts from our upcoming course, Strategic Issues for Boards, as well as information that didn’t make the cut.) MACRA creates two different tracks for clinicians to participate in Medicare. One is called the Merit-Based Incentive Payment System, or MIPS. The second is the Advanced Alternative Payment Model (AAPM). Each of these […]
About half of hospital-based physicians said they were not knowledgeable about the Medicare physician pay overhaul (Medicare Access and CHIP Reauthorization Act of 2015—MACRA) that began earlier this year, according to a recent survey by KPMG and the American Medical Association. This represents a larger share compared with physicians in other settings. The survey […]
Last week we covered the first four elements for structuring cardiac payment bundles. These included establishing clear and achievable goals, focusing on inpatient costs and reducing care variations, being guided by data and focusing on medication management and compliance. The remaining three elements are: Reorganize to manage post-acute spending. Effective cost management requires a […]
The ability to implement effective strategies to minimize risk will become increasingly important in determining not-for-profit and public hospitals’ credit strength in the changing landscape. These hospitals are focused on risk management to avoid pitfalls and capitalize on new opportunities in anticipation of momentous changes, not the least of which is the fate of the […]
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) determines only Medicare Part B payment, but hospitals and health systems will be affected through their employed and affiliated physicians. So those organizations are working to help their physicians succeed under the payment system, which will mean moving as quickly as possible to advanced alternative […]
Policy experts recently weighed in on the future of the bundled payment program. Uncertainty has been the byword since the current administration delayed the start of the latest mandatory bundled payment program. Some have speculated that such models are “on their way out.” There is no consensus among experts. A review of the background: […]
(Originally published in Nasdaq’s MarketInsite, March 30, 2017, and written by Gordon Clark, President and CEO of iProtean, now part of Veralon) Cyberattacks. They are perhaps the most vexing security threats facing businesses today. To have a computer connected to the outside world is by definition to be vulnerable. Yet an analysis published in The NTT […]
(Excerpts from a presentation by Seth Edwards, Premier, Inc. at the iProtean, now part of Veralon Symposium, March 2017) Helpful Acronyms and Definitions: MACRA: Medicare Access and Chip Reauthorization Act of 2015 QPP: Quality Payment Program—basically, a regulation that enacts the MACRA legislation MIPS: Merit-based Incentive Payment system—one of two tracks created under MACRA […]
A study in Health Affairs’ April issue found that hospitals might experience larger-than expected Medicare payment cuts under the Medicare Access and CHIP Reauthorization Act (MACRA). The report’s authors estimated that “MACRA will decrease Medicare spending on physician services by −$35 to −$106 billion (−2.3 percent to −7.1 percent) and change spending on hospital services by $32 […]