The report finds that being part of an ACO allows clinicians to be rated as a group for a key measure to determine Medicare reimbursement.

Published Online: March 30, 2017

Mary Caffrey

Joining an accountable care organization (ACO) could help clinicians raise key Medicare performance scores up to 30%, which boosts their chances of higher reimbursement relative to competitors, according to a new report from Caravan Health.

The report, by Lynn Barr MPH, CEO of Caravan Health, and LeeAnn Hastings, JD, MPH, a compliance officer for 23 ACOs under the Medicare Shared Savings Program (MSSP), compared what payments will look like for clinicians inside and outside ACOs under the Medicare Access and CHIP Reauthorization Act (MACRA, passed in 2015 to push healthcare toward value-based payment.

Under MACRA, performance data reported from 2017 will be used to calculate payments in 2018. CMS has worked to ease the transition to value-based payment, allowing clinicians to select how quickly they want to take on the associated risk. In fact, reporting a small amount of data for 2017 can help clinicians avoid penalties.

Most health plans are missing key socioeconomic data required to develop meaningful population health management programs for vulnerable patients.

Source: Thinkstock

 By Jennifer Bresnick

March 07, 2017 - Managed care policymakers do not have access to enough clean, complete, and accurate socioeconomic and population health data on the millions of patients depending on public insurance programs for care, according to a new article in Health Affairs.

“To reduce disparities, it is critical to first know where they exist,” said the research team from CMS and NCQA.  “Improving documentation of race, ethnicity, and language needs in managed care plan reporting, regardless of data collection method, and clarifying how high-performing health plans achieve their results, will be important.”

EHR technology is one of many health IT systems necessary for success in adopting ACO models, a realization that has led to a new market for developers of end-to-end ACO solutions.

Source: Thinkstock

 By Kate Monica

March 06, 2017 - The lack of standardization in implementing accountable care organizations (ACOs) has created a demand for solution vendors capable of assisting healthcare organizations in seamlessly adopting these value-based care models.

A recent report from Chilmark Research evaluates the 10 leading ACO solution vendors for their capabilities and core competencies in providing a range of services for successful ACO adoption in an effort to help healthcare organizations make informed decisions about which vendor best suits their needs.

The population health management IT market is slated for significant expansion as providers look to improve interoperability and meet patient expectations.

Source: Thinkstock

 By Jennifer Bresnick

March 06, 2017 - Over the next five years, the population health management technology market is predicted to grow into a $42.54 billion opportunity, according to a Research and Markets report, but healthcare providers will need to adopt new care strategies at a similarly rapid pace if they are to make the best possible use of newly available data analytics tools.

As regulatory programs like MACRA and meaningful use, an aging population, and an increasingly complex chronic disease population continue to challenge the status quo of patient care, providers will need to focus on leveraging population health IT tools to optimize coordinated care delivery.