2/ @AledadeACO is proud to be the largest, most successful nationwide enabler of physician-led ACOs, delivering better care at lower cost for >340,000 Medicare beneficiaries, saving Medicare and American taxpayers nearly $180 million in unnecessary health care spending last year!
3/ Here's the list of the physician-led ACOs we are supporting, and our performance data.
* It doesn't matter if you're urban, rural, suburban, or in which state
* It gets better. The longer you work, the more the chances of success
* More risk = Higher rewards
4/ Last year was also the first year of the new Pathways to Success program. Every single one of Aledade’s MSSP ACOs who switched to Pathways to Success (higher risk/ higher reward) achieved savings. Every single one!
8/ "The trauma of the pandemic has underscored the need for a resilient health care system where reimbursement is not tied to volume of services provided, but rather to value-based incentives to keep patients healthy"
(We @AledadeACO are growing like crazy in the midst of COVID)
9/ We can least afford to lose practices in rural areas that are often the only source of primary care, and supporting them is a particular source of pride for us.
1/ When Walmart enters any business you can expect that they will leverage their massive scale to get better economics, create value for customers- and drive out local mom and pop competitors
Thats what many assumed would happen w primary care clinics
but it didn't
why not?
2/ The first thing I have to acknowledge is to rule out "execution"
They aren't perfect (their Athena and Epic EMR travails show that) but Walmart knows how to execute, and they won't scale something until they've figured out how to make it profitable.
They couldn't
3/ To their credit, they tried a lot of permutations over the past 10 years, and strictly as an operator, you have to give them respect that they could be a force
- Third party vendor
- Walmart Health clinics
-Oak St Health
- Own clinics + telehealth
You've read the headlines ("Medicare pay cuts partially averted") but to understand what led us here--and what's to come-- we need to go deeper
Also, some cool tangents on effective/ineffective financial incentives
2/ let's walk through the weeds of
"a temporary patch on an expiring pandemic patch for the unintended consequences of a good-will effort to fix pay imbalance between primary care & specialists, made worse by a failure to predict future inflation, w a sop to value-based pay"
3/ The "failure to predict medical inflation"
remember the annual "doc fix" scramble? it was because the "sustainable growth rate" was indexed to inflation, which was near zero for years. So Congress had to constantly step in to reverse its own past efforts to control costs. 😧
1/ Let's flip through the Physician Fee Schedule Final Rule just out, w shared savings focus
Here's a little trick to get past all the pesky comments (that people spent 1000's of hours developing and submitting), and right to the meat of the matter:
CTRL-F "we are finalizing"
2/ First up: we want to increase participation!
strong evidence for providing upfront capital, especially to rural, underserved, low income ACOs (see AIM)
Good idea to expand it 👍
Lots of comments about eligibility criteria, repayment, etc etc.
"finalized as proposed"
3/ We want to increase participation!
Let's allow folks to stay in one sided risk for longer, especially lower income (no hospital) ACOs