January 12, 2017

ACO roundup: Do value-based payments improve health outcomes?

Daily Briefing

The Daily Briefing editorial team rounds up recent accountable care news.

  • Most medical groups concerned about MACRA regulations. Several surveys show that physicians are cautious about MACRA regulations and about Merit-based Incentive Payment System (MIPS) requirements in particular, suggesting that public and private payers might need to improve training in value-based care, HealthPayerIntelligence.com's Vera Gruessner writes. For instance, a recent Advisory Board survey found that 70 percent of medical groups were "concerned" about MACRA regulations—and only 50 percent expected to satisfy the law's reporting requirement for all of 2017. Meanwhile, a Black Book survey from 2016 found that 67 percent of physician groups that had five or less physicians and a large volume of Medicare beneficiaries expected to be forced to shut down their practices under the MIPs and MACRA requirements, while 89 percent of small medical practices were looking to decrease their Medicare patient volume under MACRA.

  • ACOs help speed readmissions reduction. A new Health Affairs study finds that Medicare ACO-affiliated hospitals are able to reduce 30-day readmissions from skilled nursing facilities at a faster rate than non-ACO hospitals. Using Medicare data from 2007 to 2013, the researchers examined readmissions rates before and after two CMS ACO programs—the Medicare Shared Savings Program (MSSP) and the Pioneer model—launched. During that period, non-ACO hospitals reduced readmissions by 13.1 percent, Pioneer ACOs by 14.9 percent, and MSSP ACOs by 17.7 percent.

  • Analysis suggests alternative payment models don't promote positive health outcomes. After reviewing 69 studies on value-based payments and quality, researchers in a new meta-analysis in Annals of Internal Medicine found "low-grade evidence that [pay-for-performance] programs in outpatient care may improve process-of-care outcomes" and "low-level evidence that the incentives made little or any difference in changing intermediate health outcomes," Medscape reports. The analysis found that in hospital settings, value-based payments likely have little or no effect on patient health outcomes but a positive effect of readmissions. Overall, the review says, there is "insufficient evidence to characterize any effect [of value-based payments] on patient health outcomes."

From Advisory Board:

  • Understand CMS' final rule expanding mandatory bundled payments. Join Advisory Board experts for a webconference on Friday, January 13, to learn about CMS' much-anticipated final rule expanding mandatory bundled payments to new services and new markets—and what providers need to do to prepare for the program's launch in July 2017.

Register now

  • What value-based care means for your pharmacy strategy. The pharmacy is playing an increasingly important role in value-based care. Join us for a webconference on Wednesday, January 18, to review how the transition from fee-for-service to risk-based payments will impact health system strategy broadly and pharmacy strategy specifically—including how to make the case for increased investment in pharmacy services.

Register now

12 things CEOs need to know in 2017

12 things CEOs need to know in 2017

The continued growth of the consumer-driven health care market threatens the durability of patient-provider relationships—and, at the same time, the push toward population health management and risk-based payment is greater than ever.

Hospitals and health systems must adopt a two-pronged strategy to respond to these pressures and serve both public payers and the private sector.

At the core of that strategy? A formula of accessible, reliable, and affordable care that wins consumer preferences and drives loyalty over time. Below, we share 12 key insights for senior executives working to create a consumer-focused health system.

X
Cookies help us improve your website experience. By using our website, you agree to our use of cookies.