June 21, 2018

ACO roundup: Most physicians participating in advanced APMs qualify for bonus, CMMI official says

Daily Briefing
    • Community health centers see surge in patient growth, report finds. Community health centers (CHC) in the United States experienced a 33% increase in patient growth between 2010 and 2016, according to a new report from George Washington University's Milken Institute School of Public Health. The report found that CHCs in states that expanded Medicaid under the Affordable Care Act generally experienced even higher increases in patient growth. Overall, according to the report, only two states—Mississippi and Wyoming—reported declines in patient growth.

    • CMMI: Most physicians participating in advanced APMs qualify for bonus. Ninety-nine of physicians who applied for the 5% bonus for participating in an advanced alternative payment model under MACRA qualified for the bonus, according to preliminary data, Gregory Woods, acting deputy director for the Center for Medicare and Medicaid Innovation, said earlier this month. Woods, speaking at the MACRA Summit on June 8, said the high percentage likely stems from the "relatively low thresholds" required for physicians participating in 2017, which was the first assessment year under MACRA. Woods said he anticipates that smaller proportions of participating physicians will qualify for bonuses in the years ahead, as requirements become more stringent.   

    • Are hospitals actually cutting readmissions—or is that just fuzzy math? A new study deepens the controversy. Data largely suggest that efforts to curb hospital readmission rates under the Affordable Care Act (ACA) are succeeding, but those declines all but disappear when observation stays are factored in to the equation, according to a research perspective recently published in the New England Journal of Medicine. For the study, researchers examined nine years' worth of claims data for commercially insured patients and found that readmissions fell by 2.3% during the study period. However, the researchers said the reduction was much lower when they factored in observation stays, which typically last fewer than three nights and are considered outpatient services, meaning they are not included in HRRP's methodology.

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    • The 2018 MIPS cost category—decoded. Join us on Thursday, August 2, at 3:00 p.m. ET, to learn the metrics included in the 2018 MIPS cost category, how providers' scores will be calculated, and strategies for improving performance.

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    • How to succeed under Medicaid risk. Join us on Tuesday, August 14 at 1:00 p.m. ET for a live panel discussion with population health, health plan, and Medicaid strategy experts from within Advisory Board to learn about key considerations for taking on Medicaid risk and setting up the right infrastructure to manage the population.

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