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March 16, 2017

ACO roundup: CMS doubles down of care coordination initiative

Daily Briefing
    • How hospitals are shaking up physician compensation. As alternative payment models that incent value instead of volume become more common, hospitals and health systems are rethinking how they compensate physicians. For example, Crystal Run Healthcare, a 300-physician group based in New York, currently ties up to 15 percent of physicians' compensation to cost, quality, and satisfaction measures. Scott Hines, Crystal Run's chief quality officer and medical director, said that fraction is slated to increase to 30 percent over the next three years because "more and more contracts are being tied to clinical quality and lower costs."

    • Providers in Houston take on the social determinants of health. Providers in Houston in 2009 formed an intervention center to better connect high-utilization patients with services outside of the hospital, such as primary care services and housing—and early results suggest the Patient Care Intervention Center (PCIC) has cut costs by moving care to non-hospital settings. For instance, in a pilot program of 39 very high utilization patients, PCIC helped cut overall costs by $2.3 million over the course of six months. The number of ED visits among the cohort also dropped significantly.

    • New CMS initiative focuses on care coordination. CMS on Wednesday announced a new initiative that aims to increase awareness of a Medicare program focused on care coordination. CMS in 2015 implemented an initiative under which it pays providers an average of $43 per Medicare beneficiary per month for certain chronic-care management services that are not provided during in-person office visits. CMS estimated that about 35 million Medicare beneficiaries are eligible for such benefits—but by the end of 2016, CMS had received claims under the program for just 513,000 beneficiaries. In response, CMS's new initiative, Connected Care, aims to boost awareness of Medicare's coordinated care benefits and give providers support to implement coordinated care programs.

    From Advisory Board

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    • What to know about the house GOP's repeal and replace plan. House Republicans recently released their proposal to repeal and replace portions of the Affordable Care Act. Join us tomorrow at 1 P.M. for a look at the key details and implications as well as the latest updates on timeline and prospects for the bill.

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    • How to grow patient loyalty. Few providers have seized today's largest growth opportunity: securing the downstream loyalty of existing patients. Join us Thursday, March 23, to learn how to optimize service connections to ensure your patients return to you when they need care next.

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