Discover and read the best of Twitter Threads about #ACO

Most recents (5)

For the #ACO wonks out there, we applied lessons from other existing or previous #ACO models to inform our approach for #BluePremier. Let’s go into a deep dive into the methodology here. [THREAD] /1
We’ll use risk adjusted, trended, historical baseline to determine shared savings/losses for the attributed population. In two-sided risk, we’ll apply a discount to ensure the plan and its ASO customers have savings even as we pass back higher amounts of savings. #HealthData /2
This fits our first lesson: meet providers where they are—try to move too fast and lose opportunity. Given this is our first broad scale total cost of care model with many of these organizations, need to start gradually. /3
Read 11 tweets
We see a lots of announcements about value-based care and #ACO contracts in our industry. Important to call out what’s new here with #BluePremier and what’s meaningful. @ASlavitt, @Atul_Gawande, @Farzad_MD, @chasedave, @SGottliebFDA /1
These 5 systems (@ConeHealth @DukeHealth @UNC_Health_Care @WakeMed @WakeHealth) are making a multiyear commitment to this program – and a commitment to two-sided risk. /2
They will be accountable for total #costofcare and quality for fully insured and self-insured lives (think large group employers). /3
Read 7 tweets
1/ 2017 #MSSP #ACO Results!
ACOs have scaled rapidly across the country!

In aggregate, the 472 ACOs were accountable for nearly 9 million Medicare beneficiaries and $95 Billion- that's a quarter of all fee for service, and almost half of the entire Medicare Advantage market.
2/ If you add up all the actual costs versus benchmarks, these 472 ACOs were collectively $1.1B under their benchmarks (more on whether that's the right counterfactual later).

Medicare shared $780 million in payments with the ACOs, netting the taxpayer $313M
But wait!

There's lots of evidence that the benchmark under-estimates the savings produced. @JMichaelMcW et al have shown convincingly that a true "difference in difference" approach would show substantially higher net impact.

The green eyeshades folks at CMS OACT said add 60%
Read 26 tweets
So right off the bat we are talking about a July 1, 2019 start where existing ACOs would extend their current contracts six months and new entrants wouldn't start till July 1. This is disruptive hopefully they left the door open to a Jan 1 start.
Very substantial changes as we thought there would be with the new administration and a long time in coming for the rule. The reg text changes themselves run 78 pages
Read 25 tweets
Here are the 2016 #MSSP #ACO results you’ve been waiting for. Results are very different for physician-only

#Physician_Led_ACOs_Kick_Butt
Sometimes the rainbows and unicorns are right in front of you
@amitabhchandra2 @Michael_Chernew @C_Garthwaite @JMichaelMcW
…And these #ACO savings are in the context of super-low per capita Medicare national inflation of about 1% per year @porszag
Read 5 tweets

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