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August 24, 2017

ACO roundup: Racial disparities narrowed after ACA, study finds

Daily Briefing
  • Racial disparities declined after ACA, study finds. Fewer black and Hispanic adults reported skipping doctors' appointments because of costs since the Affordable Care Act (ACA) took effect between 2013 and 2015, according to a new report from the Commonwealth Fund. According to the report, 21 percent of black adults and 27 percent of Hispanic adults said they skipped a doctor's visit because of cost in 2013, compared with 17 percent of black adults and 22 percent of Hispanic adults in 2015. "The [ACA's] health insurance coverage provisions have helped the [United States] make progress toward ensuring that everyone, regardless of race or ethnicity, has access to the health care they need," Pamela Riley, a co-author of the report, said.

  • CMS revamps Medicare website to help providers track ACO patients. CMS has updated the Medicare website to help providers know which beneficiaries they will be held responsible for as participants in a Medicare accountable care organization (ACO), Virgil Dickson writes for Modern Healthcare. The Medicare website now allows beneficiaries to list their primary care provider, and if that physician in participating in an ACO, the beneficiary is assigned to the provider and the corresponding ACO at the start of the following year. If a beneficiary selects a provider who is not participating in an ACO, the beneficiary will not be eligible for ACO participation. According to Dickson, CMS implemented the voluntary selection process in response to providers requesting information at the beginning of the performance year as to which beneficiaries they will be held accountable for, rather than having patients retroactively assigned to ACOs.

  • How the industry is reacting to Trump's MACRA changes. Industry stakeholders generally praised the Trump administration's proposal to scale back some MACRA requirements, but some groups, such as the American Medical Association (AMA) and the American College of Rheumatology (ACR) raised concerns about how the proposed changes would affect payment calculations. For instance, ACR wrote that it "appreciates many components of the proposed rule," but "continues to be highly concerned about the nature of Medicare Part B payments that are subject to MIPS payment adjustments." AMA also raised concerns with the proposed methodology for MIPS payment, particularly CMS' plans to establish improvement scoring. "This additional scoring consideration will add complexity to an already complicated program and require physicians to factor in additional considerations when they are just trying to learn the program," AMA said.

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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