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- Janet on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Kristina on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Curt Black on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Margaret on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Jane Wall Medicare Health Benefits Inc on Strange Bedfellows Come to Medicare Advantage’s Rescue
Anyone who has paid attention knows that since 2011 more than 200 Medicare ACO’s have been operationalized. If you add in commercial ACO’s, the number is closer to 400.
Thirty-two Pioneer ACOs sent a correspondence to CMMI in late February, suggesting that they would exit the Pioneer ACO program if CMS did not accept their recommendations for changes to the quality measures employed to determine pay for performance in the Pioneer program. As a group, the Pioneer ACOs suggested to CMMI that because of their collective experience with performance based contracts and performance reporting on quality measures, they — not CMMI – know what works and what doesn’t when it comes to benchmarking quality to reimbursment.
A recent article in CMS’s journal, Medicare and Medicaid Research Review, reinforces our concerns about the prospects for small Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP). It appears that size does matter for these provider systems, and that small ACOs are extremely vulnerable to flaws in CMS’s gainsharing methodology.
In a recent webinar we predicted that we would see $300-500 Billion in savings from Medicare and Medicaid in a deal to avoid the fiscal cliff. The shapes in the fog are becoming clearer and we’ll stand by it: Senate Majority Whip Dick Durbin said this morning on MSNBC’s “Morning Joe” that he’d like to see around $400 Billion in cuts from Medicare as lawmakers negotiate a deal to avoid the fiscal cliff.
An old, dear friend of mine and fellow XLHealth Board member, Stuart Altman, was just appointed chief of healthcare cost containment for Massachusetts’ ground-breaking reform effort — a harbinger of things to come nationally as the Affordable Care Act now hurtles toward implementation. The local NPR affiliate did a great interview with Stu that I wanted to share here. As always, Stu brings tremendous insight and a sense of history and trends to his work, and as goes Massachusetts, so will go the rest of the country in 2014 and beyond. Read more
It’s hard to argue this wasn’t a decisive victory for the President and Democrats in the Senate. What remains to be seen is whether intractable Congressional Republicans will come to the table to get stuff done.
The June 18th blog by my colleague and friend William MacBain posed a valid question when he asked whether Medicare ACO’s are a revolution in healthcare or a side show. My view–it’s that and more. To the point that Medicare ACO’s will probably have only a minor impact on overall Medicare expenditures, I totally agree but would argue that significantly reducing Medicare expenses is not the overriding goal of the CMS sponsored shared savings program. I believe the overriding goal is to stimulate provider change in how healhcare is priced, delivered and made accessible to those who need it.