Stephen Nuckolls, CEO of Coastal Carolina Health Care, New Bern, N.C., shared some lessons at the Medical Group Management Association annual conference yesterday from his organization's experience in running a Medicare accountable care organization.
He said that when his organization was forming its 50-provider accountable care organization, hiring a consultant was money well-spent, but outsourcing the staff of its after-hours call center was not. The consultant offered concrete steps to advance the ACO goal of keeping people out of the hospital and emergency department. But the employees of the contracted call center company worked against that goal.
Read more »
A Medicare test of accountable care in Wisconsin slowed cost growth last year for about 20,000 seniors. That's good news, of course, to economists and policymakers. But for hospitals, the news was not all good because most payers continue to reimburse on a fee-for-service basis rewarding more admissions and more volume of services.
An article in the Journal of the American Medical Association said that for hospitals that participate in Medicare accountable care programs, such as ThedaCare in Appleton, Wis., competing financial incentives can make their ACO efforts counterproductive.
Read more »
Spending on healthcare is expected to rise just 4.5% next year as employers and providers make a number of moves to bring down costs.
In its annual Behind the Numbers report, PricewaterhouseCoopers' Health Research Institute is forecasting a medical cost trend of 6.5% for 2014—offset by health insurance changes that will effectively lower that number two percentage points.
Read more »
Larger independent physician groups with “strong primary-care orientations” and where doctors have accepted greater financial risk deliver better quality care for Medicare beneficiaries at lower cost, according to a report in JAMA Internal Medicine.
Researchers with Harvard Medical School's healthcare policy department studied 2009 Medicare claims for almost 4.3 million beneficiaries and compared spending and quality measures for small (one to 10 doctors), medium-to-large and hospital-based physician groups. Quality measures included 30-day hospital readmissions, and mammography, diabetes and cholesterol screening for the appropriate patients.
Read more »
Fledgling accountable care organizations have faced plenty of challenges. Now a group of economists and lawyers are calling for a close look at issues involving insurance, antitrust and other regulation to avoid “unintended consequences.”
Health policy experts Gary Bacher, Michael Chernew, Daniel Kessler and Stephen Weiner write in the latest issue of the policy journal Health Affairs that ACOs could stifle competition among insurers and providers and potentially drive up prices.
Read more »
