What you need to know about the forces reshaping our industry.


October 12, 2017

ACO roundup: ACOs taking on more risk, but slow to change care delivery, survey finds

Daily Briefing
    • HDHPs linked to lower health care costs, utilization, study finds. High-deductible health plans are associated with lower health care costs as a result of enrollees' reduced use of health care services, according to a study in Health Affairs. For the study, researchers reviewed 28 prior studies on how high-deductible health plans affected health care costs and use. The study found that the plans were associated with a "significant" reduction in the use of preventive services—even though many high-deductible plans do not charge enrollees for preventive care—as well as fewer office visits and, potentially, a reduction in medication adherence.

    • Survey: ACOs taking on more risk, but slow to change care delivery. ACOs are increasingly participating in risk-based contracts, but few are advancing "aggressive" care redesign strategies—which could undermine their performance on downside risk contracts, according to a survey overview published in Health Affairs Blog. The researchers found that while 90 percent of surveyed ACOs were participating in at least one upside-only shared savings contract, just about half of respondents said they were participating in a downside-risk contract. Forty-seven percent said they intended to participate in a shared-savings and shared-risks contract and 38 percent said they had plans for capitation. Yet despite increased interest in risk-based contracts, the majority of respondents said they were still in the early stages of redesigning care delivery—and relatively few indicated they were engaged in "more aggressive care delivery changes," the researchers found. Based on the findings, the researchers cautioned that provider-based risk "cannot be pushed faster than ACOs' ability to manage it."

    • MedPAC pans MIPS, may urge Congress to scrap it. The Medicare Payment Advisory Commission (MedPAC) during a meeting last Thursday discussed whether the commission should recommend Congress eliminate or replace MACRA's Merit-based Incentive Payment System (MIPS). During the meeting, MedPAC members suggested that MIPS' flexibility makes it overly complex and said the program is unlikely to achieve its intended policy goal of rewarding high-quality care. Ultimately, Commission Chair Francis Crosson tasked MedPAC's technical team with developing draft recommendations for repealing MIPS and replacing it with a voluntary program, as well as ways to increase physician access to advanced payment models.

    From Advisory Board:

    • How to reduce avoidable ED utilization. Heightened demand for emergency services and increased consumerism in health care has left EDs overburdened with rising costs and volumes. Since the majority of these visits are considered unnecessary, provider organizations can capitalize on the opportunity to cut avoidable ED visits. Join us on Wednesday, Oct. 18, to learn tactics to increase patient access to primary care, inflect patient behavioral change by boosting awareness of alternate care points and self-management strategies, and implement targeted measures for high-risk patients.

    Register Here

    • 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.

    Get the Report

    Register Here

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.