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May 11, 2017

ACO roundup: Penalties are growing under HRRP, study finds

Daily Briefing
  • Penalties are climbing under HRRP, study finds. The average penalty levied under CMS' Hospital Readmissions Reduction Program (HRRP) grew modestly from 0.29 percent to 0.60 percent during the program's first five years, despite the program's expansion and maximum penalty increases, according to a Health Affairs study published last week. The researchers also found that the penalty burden was greater for certain hospitals, including those that are for-profit, large, serve as teaching hospitals, treat larger shares of Medicare or socioeconomically disadvantaged patients, or urban. Concluding that HRRP leads to persistent penalization that limits the capacity for hospitals to reduce penalty burden, the researchers suggested that "alternative structures" could help hospitals avoid frequent penalizations, while still encouraging hospitals to reduce readmissions.

  • CDC releases guidance to facilitate physician-pharmacist partnerships. CDC's Division for Heart Disease and Stroke Prevention has collaborated with the American Medical Association and the American Pharmacists Association to develop a new guide aimed at facilitating partnerships between physicians and pharmacists. Among other resources, the guide features examples of existing community-clinical partnerships and details about collaborative drug therapy management programs.

  • AAFP asks CMS to simplify MACRA implementation. The American Academy of Family Physicians (AAFP) in a recent letter called on CMS to simply MACRA implementation requirements for providers. Among other suggestions, AAFP recommended the agency eradicate the MIPS APM category, end "administrative claims population health measures," and use consistent language throughout the rulemaking process to avoid confusion among providers. "Given the significant complexity of these programs, we strongly encourage CMS to follow the AAFP's recommendations by which CMS can better align the requirements with the goals and intent of the legislation," the letter stated.

From Advisory Board:

  • What the best patient access initiatives do differently. Even though health care reform is in a state of uncertainty, one thing is for sure: helping consumers access care in your ambulatory network is a priority no matter the political outcomes. Join us May 22 to learn what makes the most successful patient access initiatives stand apart from the crowd.

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  • How to pick the right Medicare ACO program. With the government's continued focus on alternative payment models and the implementation of MACRA underway, providers must confront major Medicare contracting decisions. Join us on May 12 to learn how to evaluate risk for your fee-for-service Medicare population with the Health Care Advisory Board's latest analysis of the Medicare ACO programs.

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