ACO roundup: ED patients struggle to arrange prompt follow-up care, study finds

Key accountable care news from the past week

  • ED patients struggle to arrange prompt follow-up care, study finds. Patients frequently have difficulty arranging a follow-up visit with a primary care physician within seven days of discharge from the ED, according to a study in the Annals of Emergency Medicine. For the study, individuals posing as recently discharged ED patients in New Haven, Connecticut, called 53 primary care practices a total of six times each, using a variety of scripts to differentiate insurance types and health conditions. The researchers found that the callers successfully arranged an appointment within a week of discharge only 30.7 percent of the time. "Our findings demonstrate the need for close partnerships between EDs and primary care providers to improve access to acute and primary care," the researchers said.

  • Most Pioneer, Next Generation ACOs generated shared savings in 2016, CMS data show. A majority of the accountable care organizations (ACOs) participating in CMS' Pioneer ACO and Next Generation ACO models during the 2016 performance year experienced shared savings, according to CMS data released Friday. The data show six of the eight ACOs that participated in the Pioneer program for the 2016 performance each completed the year with at least $1 million in shared savings. CMS also released data that show 11 of the 18 Next Generation ACOs that participated in 2016—the model's first performance year—generated shared savings.

  • AMA launches program aimed at facilitating interoperability. The American Medical Association is launching the Integrated Health Model Initiative, which aims to establish a framework for industry stakeholders to gather, organize, and share information. According to Jeff Smith, AMA's VP of public policy, the organization's initiative will complement similar efforts by the Office of the National Coordinator for Health IT to boost interoperability by facilitating data exchange. AMA's project will initially focus on data exchange for three chronic conditions: asthma, diabetes, and hypertension, Rachel Arndt writes for Modern Healthcare.

From Advisory Board:

  • How to reduce financial toxicity. The rising cost of drugs is placing an increasing financial burden on patients, in many cases leading them to delay or forgo care or default on their medical bills. Join us on Tuesday, Oct. 24, to learn best practices for helping patients understand their insurance coverage, estimate and plan for their out-of-pocket expenses, and secure copayment assistance or drug replacement.

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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 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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