December 14, 2017

ACO roundup: MSSP savings not linked to preventable hospitalizations, study finds

Daily Briefing
    • MSSP savings not linked to preventable hospitalizations, study finds. Hospitalizations for patients in the Medicare Shared Savings Program (MSSP) did not decline between 2012 and 2014—a finding that suggests curbed hospitalizations did not account for the program's net savings, according to a new Health Affairs study. Specifically, the study found that while overall hospitalizations among patients in the program declined by 1.6% in 2012, they declined by only 0.7% in 2013 and increased by 0.3% in 2014. Further, according to the study, preventable hospitalizations did not decline between 2012 and 2013 and increased in 2014. However, the researchers noted that while the study found that the program didn't reduce hospitalizations, it does not suggest that the program did not improve overall care quality for patients.

    • No, the uninsured don't use the ED more than the insured, study finds. Contrary to a widespread belief, uninsured adults are no more likely to use the ED than insured adults, according to a study published in Health Affairs—but the study also offered a potential explanation for how the belief arose in the first place. Citing their findings, the researchers explained that while about 13.7% of patients who had either private or public insurance coverage used the ED in 2013, there was a stark difference in usage rates for outpatient care: About 77% of adults with private insurance and 75% of adults with Medicaid used outpatient services in 2013, compared with 42% of uninsured adults. According to the researchers, the myth that uninsured people use the ED more heavily than insured patients could stem from the fact that uninsured patients "are most likely encountered in the ED," as such patients are relatively unlikely to use outpatient services.

    • Report: Fewer people delayed care, struggled to pay medical bills under ACA. Fewer U.S. residents are delaying medical appointments or struggling to pay medical bills because of insurance gains made since the implementation of the Affordable Care Act, according to a new report from the Commonwealth Fund. Specifically, the report—based on CDC data—found that between 2013 and 2016, the proportion of adults saying they postponed medical care because of cost concerns declined in 45 states, while the proportion of adults at risk of poor health who had not seen a doctor in the past two years declined across 37 states. Further, according to the report, the share of working-age adults who reported high out-of-pocket costs for medical procedures dropped in 35 states between 2013 to 2014 and 2015 to 2016.

    From Advisory Board:

    • Get the 2018 oncology Medicare reimbursement update. Join us today, Dec. 14, at 3:00 p.m. to hear a complete analysis of the changes in 2018 Medicare payment for cancer services. We'll provide updates on site neutrality and 340B regulations. We'll also cover in-depth reimbursement changes for chemotherapy, radiation therapy, and imaging in both the hospital-based and freestanding settings.

    Register Here

    • Partner with physicians in enterprise cost control: Part 1. Join us on <strong>Friday, Jan. 12</strong>, to learn how to reduce the cost of clinical variation, by establishing expected clinical practice and translating standards into frontline care delivery.

    Register Here

    Register Here

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