Health plans of all sizes are interested to learn where they stand in the movement toward alternative payment models (APMs) – that is, shared savings, shared risk, bundled payments, or population-based payments and how they compare to the market. Some health plans adopt APMs because of market conditions, others by factors such as data system limitations or provider readiness.
Health plans benefit from monitoring changes to Medicaid MCO contract requirements, including those related to alternative payment models (APMs) adoption. MCOs with APM experience may have a competitive advantage when bidding on state contracts; conversely, MCOs that lack the capacity to implement APMs may be at risk of losing Medicaid business.
As 2016 comes to a close, now is the time to look at what healthcare trends might bring us into 2017. Current healthcare trends can help healthcare organizations predict changes in the marketplace and isolate places of improvement. From ACOs to behavioral health, here 3 important trends to watch as we enter 2017.
The shift to accountable care and value based payment models is coming. Accountable Care Organizations (ACOs) are just one of the value-based models making waves throughout the healthcare industry. Based on current growth trends it is predicted by 2020 approximately 70 million people will be covered by ACOs. Focusing on shared accountability and quality improvement, ACOs have become champions of the healthcare triple aim. Not to mention a major player in CMS’ plan to tie a large percentage of payments to value by 2017. As ACOs soar in popularity now is the time to weigh your options. Are you are thinking or making the transition to an ACO? What are the benefits
The shift to accountable care and value-based payment models is taking healthcare by storm. Accountable Care Organizations (ACOs), which focus on shared accountability and quality improvement, are becoming a popular model for many healthcare organizations looking to move forward in the new era of healthcare. Around 7.7 million Medicare beneficiaries receive care from an ACO. This has resulted in better care for the beneficiaries and a reduction in total costs.
The number of Accountable Care Organizations (ACOs) in the U.S. is growing rapidly, causing major shift in the healthcare landscape. ACOs are provider lead organization with a strong primary care base. What makes them different from other healthcare models is that ACOs are collectively accountable for quality, costs and the full continuum of care for their patients. Encouraged by the Affordable Care Act, this type of shared-risk model, which also falls under value-based, is becoming a good option for many providers.
Traditional incentive based payment models are being put phased out. The Centers for Medicare & Medicaid Services (CMS) is now pushing for alternative payment models that focus on quality of care rather than quantity. The CMS hopes to tie 90% of all Medicare payments to alternative payment methods by 2018. To support this transition CMS has proposed changes to the Medicare Access and CHIP Reauthorization Act (MACRA), which focuses on changing the way providers are reimbursed for care.
Signed into law in 2015, the Medicare Access and CHIP Reauthorization Act (MACRA), centers on reimbursing providers for the value and quality of care they provide. The MACRA Quality Payment Program (QPP) is a proposed shift to the law itself and many healthcare organizations weighing-in.
UnitedHealthcare announced it will be partnering with DeKalb Physician Hospital Organization in Georgia, to launch an accountable care program. The program hopes to improve both patient care and satisfaction through better coordinated care and shared risk.
Accountable Care Organizations (ACOs) are a hot topic in the healthcare industry. From shared accountability to quality improvement, ACOs are fully embracing the healthcare triple aim. If you are thinking of creating an ACO now would be the time. Based on current growth trends it is predicted by 2020 approximately 70 million people will be covered by ACOs, and some industry experts estimate coverage will expand to 150 million people by 2025.