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March 22, 2018

ACO roundup: 7 Next Generation ACOs leave the program

Daily Briefing
    • Multiple Next Generation ACOs depart. Seven Next Generation ACOs have exited the program, marking the largest departure since the program launched three years ago, Politico's David Pittman reports. According to Pittman, the Accountable Care Coalition of Chesapeake, Allina Integrated Medical Network, Fairview Health Services, KentuckyOne Health, LifePrint, MemorialCare, and Sharp Healthcare  are no longer listed as participants on CMS' website, leaving the program with 51 participating organizations.

    • Value-based care requires patient empowerment, CMS official says. To transition successfully to value-based care models, the health care industry must empower patients to take more control over their care, Demetrios Kouzoukas, principal deputy administrator for CMS, told the House Ways and Means Committee on Wednesday. Kouzoukas said CMS' latest push toward interoperability—the MyHealthEData, which CMS Administrator Seema Verma announced earlier this month—is facilitating that shift because of its focus on empowering the patient. "Ultimately, we think that if you put patients in the position to help drive that value, you're going to get to a better place," Kouzoukas said.

    • Medicare hospital margins could hit negative 11% this year, MedPAC says. The Medicare Payment Advisory Commission (MedPAC) in its March report to Congress said that hospitals' Medicare margins are continuing to drop—a trend the commission warned could limit access to care if it continues. According to MedPAC's report, the aggregate Medicare margin for hospitals has declined from negative 5.3% in 2009 to negative 9.6% in 2016. The margin for nonprofit hospitals was negative 11% in 2016, while for-profit hospitals had a margin of negative 2.4%. Noting that aggregate margins could hit negative 11% if trends continue, MedPAC in the report said the eventual "difference between commercial rates and Medicare rates will grow so large that some hospitals will have an incentive to focus primarily on patients with commercial insurance."

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