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October 4, 2018

ACO roundup: Physician-group ACOs see MSSP savings grow

Daily Briefing

    QPP is medical practices No. 1 burden, survey finds. Medicare's Quality Payment Program (QPP)—which includes the Merit-based Incentive Payment System and Advanced Alternative Payment models—is the biggest regulatory burden facing physician practices, according to a Medical Group Management Association (MGMA) survey. The survey found 88% of practices found QPP very burdensome or extremely burdensome. However, MGMA SVP of governmental affairs Anders Gilberg, said the results "in no way ... mean folks are anti-quality or anti-value-based care."

    MSSP savings grow at physician-group ACOs. Physician-group ACOs participating in the Medicare Shared Savings Program generated significantly more Medicare savings than hospital-led ACOs between 2012 and 2014, according to a study published last month in the New England Journal of Medicine. Further, physician-led ACO savings grew over that time period. Physician group ACOs saved a net $256.4 million for Medicare in 2015, while bonuses to hospital-led ACOs offset their savings.

    Humana, Heritage enter value-based agreement. Health insurer Humana and Heritage Provider Network, a physician-led care organization, on Wednesday announced a value-based agreement to include Heritage Provider in Humana's Medicare Advantage (MA) network. Under the agreement, Humana MA HMO plan members and dual-eligibles in several counties in southern and central California will be able to choose Heritage Provider physicians for primary care, which will give them access to the integrated health care system. Humana has 70,300 MA members in California, while Heritage has more than one million patients in Arizona, California, Missouri, and New York.

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