Accountable Care Organizations

Data capture and coding for social determinants of health are works in progress, per reports

In the effort to bring social determinants of health (SDoH) more under the purview of healthcare providers, one tricky aspect is establishing a data and coding infrastructure. Recent reports highlight this challenge. For example, a survey conducted for the American Health Information Management Association (AHIMA) found that although 78% of 2,637 respondents said their organizations…

Nick Hut March 10, 2023

In federal ACO programs, advocates see signs of slow but steady progress

Growth in accountable care organization (ACO) programs has been inconsistent since the Affordable Care Act made accountable care part of the healthcare lexicon in 2010. Nonetheless, proponents are optimistic about the state of ACOs and their potential in upcoming years, even if there’s uncertainty about CMS’s ability to achieve its stated goal of ensuring every…

Nick Hut February 23, 2023

DOJ withdraws guidance that bolstered antitrust safe harbors for GPOs, cost benchmarking and more

Potentially leading to stricter enforcement of antitrust policy in healthcare, the U.S. Department of Justice has withdrawn guidance that essentially promoted certain arrangements in the industry. The Feb. 3 announcement from DOJ’s Antitrust Division amounts to a cancellation of so-called “safety zones” that were established in three sets of nonbinding guidance issued between 1993 and…

Nick Hut February 20, 2023

Healthcare News of Note: U.S. Surgeon General says the nation must stop health worker burnout

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: U.S. Surgeon General says healthcare worker burnout is a national issue that must be addressed, the Digital Health for Equitable Health Alliance was just launched, and a survey shows funding is needed for ACOs to provide more home-based services.

Deborah Filipek June 21, 2022

CMS’s overhaul of the Direct Contracting program draws praise from supporters of value-based payment

Value-based payment advocates see reason for optimism in CMS’s recent decision on the future of its Direct Contracting model.

Nick Hut March 4, 2022

Medicare’s much-hyped Direct Contracting model faces an uncertain future

Medicare’s Direct Contracting model, touted as representing the evolution of alternative payment models, could be shelved less than a year after getting started.

Nick Hut February 16, 2022

Small study finds health systems lagging in providing value-based payment incentives to physicians

Despite the increasing proliferation of alternative payment models, a new study finds that health systems generally don’t give physicians financial incentives to improve the value of care delivery.

Nick Hut February 14, 2022

Accountable care models will be almost universal for Medicare and Medicaid beneficiaries by 2030, CMS leaders say

A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.

Nick Hut October 21, 2021

Report by Medicare trustees describes a daunting payment picture for healthcare providers

The Medicare Hospital Insurance Trust Fund is on course to run out of money by 2026, and that assessment wasn’t the only concerning part for hospitals in a new government report.

Nick Hut September 8, 2021

4 keys to sustaining financial viability in the shift to value

A leading ACO in Texas has found a way to thrive despite systemic factors that can discourage value-based initiatives.

Andrew Ziskind, MD August 30, 2021
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