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September 7, 2017

ACO roundup: Few hospitals to volunteer for IPPS readmissions pilot, CMS says

Daily Briefing
  • Physician practice consolidation driven by small acquisitions, posing hurdles for antitrust regulation. Large physician practices exceed federal guidelines for market concentration in more than 20 percent of studied regions—but they manage to avoid federal antitrust regulation by growing via smaller acquisitions and individual hires rather than large purchases, according to a new Health Affairs study. The researchers assessed 2007-2013 claims data for several states, and found that half of the growth of physician groups with more than 100 doctors stemmed from acquiring practices with 10 or fewer physicians, while one-third of growth resulted from individual hires. Further, the researchers found that while 22 percent of the markets assessed qualified as highly concentrated per federal standards, only about 28 of those markets recorded an acquisition deemed potentially anticompetitive.

  • CMS: Few hospitals volunteer for readmissions pilot. CMS said it expects fewer than 100 of the 3,000 hospitals paid under Medicare's Inpatient Prospective Payment System will participate in a new voluntary pilot to test a new readmissions measure, which uses EHR and Medicare claims data to estimate 30-day readmissions rates. CMS did not indicate why so few hospitals have expressed interest, but stakeholders have voiced concerns that low participation in the pilot could make the pilot an inaccurate assessment of the measure's accuracy.

  • Medicare Shared Savings ACOs cut spending by $1B over three years, OIG says. Medicare Shared Savings Program (MSSP) ACOs cut spending by about $1 billion during the program's first three years, according to a new report from HHS' Office of Inspector General. Specifically, the report found 282 of ACOs—about two-thirds of all the 428 participating ACOs from 2012 to 2015—curbed spending for at least one of years they participated in MSSP, while the remaining 146 participating ACOs did not cut spending, and each year they surpassed their spending benchmarks. OIG also found that 82 percent of ACOs in MSSP improved quality of care, as determined by 33 quality measures.

From Advisory Board:

  • How to close the housing gap through strategic partnerships. Hospitalized patients with unstable housing often have longer lengths of stay, poorer health outcomes, and preventable costs. Join us on Tuesday, Sept. 19, to find out how innovative providers are forming partnerships to provide supportive housing options for high-risk patients.

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  • Is your Medicare risk strategy MACRA-ready? While the GOP's health reform effort continues to evolve, Medicare payment reform has quietly marched on with bipartisan support. And with MACRA well underway, the new administration has shown no signs of reversing course. As a result, hospital and health system leaders need to develop an intentional Medicare risk strategy. Check out our new research report to learn how to navigate the Medicare ACO programs, expand into the Medicare Advantage market, and ensure the longevity of your Medicare risk strategy by actively cultivating contracts over time.

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