Tag Archives: Gorman Health Group ACO

When Worlds Collide: ACOs and Risk Adjustment

John Nimsky

By John Nimsky & RaeAnn Grossman

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WSJ asks, “Can ACOs Improve Health Care While reducing Costs?”

John Nimsky

Specifically the question that the WSJ posed in its article on January 23 to three health industry experts, (Don Berwick, former CMS Administrator, Jeff Goldsmith, President of Health Futures and Tom Scully, CMS Administrator from 2001-2004) was whether ACOs are the answer to what ails the health care system. As expected, the response from each of the three respondents differed in outlook, driven by their political, professional and personal perspective.

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Capitation in Accountable Care Organizations

William MacBain

If you don’t already subscribe, we suggest you check out Accountable Care News, an online publication focused specifically on Accountable Care Organizations. 

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ACO: Change agent or fad?

John Nimsky

Aetna recently published results of two studies suggesting that ACOs can indeed cut Medicare enrollee costs. The results came from two medical groups - one in Ohio and one in Florida. The Florida group reduced inpatient hospital days by 37% and hospital readmissions by 27%. The Ohio group reduced inpatient days by 30% and hospital readmissions by 27%.  In each case the program started in 2009 - so not bad results for a 2 year program–right?

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ACOs Are Here to Stay. They will vary in form, but not function

John Nimsky

I just returned from the Second National Accountable Care Organization Congress. It was a three day conference focused on discussing the role that ACOs, public and private, will play in the movement to reengineer how healthcare services are delivered, evaluated, priced and paid f or.

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Final ACO Regulations and Guidance

Jean LeMasurier

I have finally finished reading the Shared Savings ACO regulations and companion guidance.  No wonder it took so long.  There are so many changes ranging from major policy changes to smaller changes intended to reduce burden.  In my career with CMS, I do not remember any final regulation where the policy moved so far from the policies outlined in the NPRM. It is clear that CMS really listened to all of the comments. I think CMS wants this program to work.  Initial feedback from stakeholders seems to be mostly positive. 

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