Discover and read the best of Twitter Threads about #mssp

Most recents (5)

1/ The results are in!

Quick thread on #MSSP #ACO results in @Health_Affairs blog by @SeemaCMS

Interest In ‘Pathways To Success’ Grows: 2018 ACO Results Show Trends Supporting Program Redesign Continue | Health Affairs healthaffairs.org/do/10.1377/hbl…
2/ the total net savings to CMS continue to grow!

Now $740M net of payments to ACOs

Was $314M in 2017

Note: benchmark <> counterfactual-Lots of evidence that these savings are under-estimates, not even accounting for spillover

(@AledadeACO saved taxpayer $69M on 300k Benes) Image
3/ and guess what??

Physician-led ACOs continue to generate a disproportionate share of savings in the program!

That hypothesis led me to launch the physician-led ACO learning network at Brookings in 2013, and @AledadeACO in 2014.

Evidence now obvious. Not so much then. Image
Read 5 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
During our #webinar on the #MSSP proposed rule we had a Q&A with @Farzad_MD and @Travis_Broome. We're sharing the most asked questions and answers below.

See the full webinar here: register.gotowebinar.com/register/28290…
#MSSPruletalk
Q: Do "low-revenue" ACOs have to enter "Enhanced" track if they have prior experience?
A: No, a low-revenue ACO that is inexperienced with risk can be in the BASIC glide path for agreement period 1 and Level E for their second agreement. More nuanced if experienced with risk
Q: Do percentage regional benchmarks apply to new start ACOs? What does percentage benchmark mean?
A: Regional benchmarks will now start in agreement period 1 (35% for efficient, 25% for inefficient). Independent practices tend to be more regionally efficient!
@HRDahlman
Read 20 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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