ACO roundup: How Penn Medicine cut readmissions by 25% under new value-based contract

Key accountable care news from the past week

  • Penn Medicine cuts readmissions by 25% under new contract. The University of Pennsylvania Health System this month announced that its hospital readmission rate declined by 25% during the first year of a new, five-year contract with Independence Blue Cross. According to Philly.com, Independence under the contract no longer reimburses Penn Medicine when patients are readmitted within one month of discharge. Penn Medicine now has a scheduler work with patients at high risk of readmission to coordinate their follow-up appointments. Penn Medicine also established dashboards to monitor follow-up appointments at seven and 14 days post-discharge, and the health system ensures most patients are discharged with all necessary medications in hand to avoid delays in care, among other initiatives.

  • CMS plans to assess quality measures for home health agencies. CMS in a federal notice said it plans to administer a survey to learn how well home health agencies (HHAs) are performing under the agency's current quality measures, and whether new quality measures are needed for better assessment. According to Modern Healthcare, the survey—if approved by the White House—would be administered in August 2019, with the results scheduled to be published in a peer-reviewed journal by 2021. CMS said of the survey, "Despite the established use of CMS quality measures in HHAs, CMS lacks information regarding the impact of their use and how HHAs are responding to them."

  • How providers want Medicare to ease its anti-kickback laws (and what it means for value-based care). Earlier this year, the Trump administration asked for recommendations on ways to ease anti-kickback laws that limits where physicians can refer Medicare beneficiaries. Providers and lobbying groups responded in force—but some legal experts say any move to ease existing laws could increase fraud and abuse.

From Advisory Board:

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  • The 2019 Imaging Market Outlook. Join us on Wednesday, December 5, at 3:00 p.m. ET to learn about the rising tide of cost control, payer steerage, regulatory changes, and patient consumerism affecting imaging providers in 2019 and beyond.

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  • Cancer care reimbursement in 2019, explained. Join us on Tuesday, December 11, at 3:00 p.m. ET to learn about changes in the 2019 HOPPS and MPFS Medicare rules impacting payment for cancer services in the hospital-based and freestanding settings.

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