Accountable Care Organizations

Payers Enter New Value-Based Care Agreements with Providers

by Thomas Beaton

Commercial payers including Aetna, Cigna, and Tufts Health are launching new value-based care agreements with providers to reduce healthcare costs and increase care quality for beneficiaries. Many...

UnitedHealthcare Finds Value-Based Care Closed 50M Gaps in Care

by Thomas Beaton

Value-based care helped close 50 million gaps in care between 2013 and 2017 while reducing care costs, lowering ED utilization, and increasing provider care quality, according to a new report from...

Payer, Provider Collaboration Required for Accountable Care Success

by Thomas Beaton

The accountable care organization (ACO) movement has gained traction over the last year as payers and providers begin to share the same viewpoints on the benefits of value-based care. Provider...

Mercy Health, Centene Form Medicaid Accountable Care Organization

by Thomas Beaton

Mercy Health of Arkansas and the Centene Corporation have received approval to operate an accountable care organization within the state focusing on Medicaid beneficiaries, the organizations announced...

Michigan MSSP Accountable Care Org Saves $8M for Medicare

by Thomas Beaton

The Physician Organization of Michigan Accountable Care Organization (POM ACO), a Medicare Shared Savings Program (MSSP) ACO, helped the state save $8 million dollars on Medicare expenses by reducing...

Payer Pricing, Partnership Strategies for Population Health

by Thomas Beaton

Effective population health management and comprehensive preventive care open the door to new opportunities that maximize payer spending, raise care quality, and slow the progression of costly chronic...

Medicaid Analytics Support Social Determinant Incentive Payments

by Thomas Beaton

Payers looking for innovative ways to control the costs of care have been turning their attention to the social determinants of health, the non-clinical factors that often lead to issues with care...

Medicare Shared Savings Program ACOs Cut Spending by $1 Billion

by Thomas Beaton

Accountable care organizations in the Medicare Shared Savings Program (MSSP) lowered net spending by $1 billion and could help control high expected Medicare spending in the future, a report from the...

Tufts Health Plan Launches Four Medicaid ACO Partnerships

by Thomas Beaton

Tufts Health Plan has signed contracts to form Medicaid accountable care organizations (ACOs) with Atrius Health, Beth Israel Deaconess Care Organization, Cambridge Health Alliance, and Boston...

Can Healthcare Payers Inspire ACOs to Take on Two-Sided Risk?

by Jennifer Bresnick

While two-sided risk arrangements are attractive for healthcare payers, even experienced accountable care organizations (ACOs) are wary of jumping into contracts which make them financially responsible...

Guides Help Employers Decide on Accountable Care Organization Use

by Thomas Beaton

The National Business on Health Group (NBHG) has released two comprehensive guides to help employers evaluate the pros and cons of using accountable care organizations (ACOs). Both resources are part...

Understanding the Basics of Accountable Care Organizations

by Jesse Migneault

Accountable care organizations (ACOs) are provider-based networks which utilize data analytics and population health management strategies to increase efficiency, improve patient outcomes, and reduce...

OR May Cut ACA Medicaid Expansion Funds to Favor State Budget

by Jesse Migneault

The Oregon state legislature is considering a retraction of Medicaid expansion and benefits to address an anticipated $1.8 billion budget shortfall between 2017 and 2019.  The move to cut back...

Patient Satisfaction Key for Payer Measurement of ACO Quality

by Thomas Beaton

An article from the American Journal of Managed Care reveals that patient satisfaction within an accountable care organization (ACO) is a strong indicator of the care quality level the organization...

CMS Solicits Payer Participation to Next Phase of CPC+

by Thomas Beaton

In support of second round of payer solicitation for Comprehensive Primary Care Plus (CPC+), The Centers for Medicare & Medicaid Services (CMS) has issued a list of frequently asked questions aimed...

Two-Sided Financial Risk Model Reduces Socioeconomic Disparities

by Thomas Beaton

A two-sided financial risk model that encourages population health management significantly narrowed the care disparity gaps between different socioeconomic groups, according to a study from Harvard...

State Medicaid Programs Invest in Accountable Care Organizations

by Vera Gruessner

Last month, the Center for Health Care Strategies released a fact sheet outlining the growth of state Medicaid programs operating accountable care organizations (ACOs). Right now, there are...

Should Accountable Care Organizations Include Social Services?

by Vera Gruessner

While government agencies, healthcare payers, and medical organizations put their efforts and hopes in advancing accountable care organizations (ACOs), these healthcare delivery reforms lack...

How CMS Alternative Payment Programs Impact Healthcare

by Vera Gruessner

Over the last five years, the Centers for the Medicare & Medicaid Services (CMS) has released many new payment systems for Medicare providers including shared savings, pay-for-performance programs,...

Highmark Partners with Aledade’s Accountable Care Organizations

by Vera Gruessner

In December 2016, Aledade Inc., a leader of accountable care organizations (ACOs), and Highmark Blue Cross Blue Shield announced in a company press release a new partnership to provide quality medical...