If there's anything that's become clear about this ACO business lately, it's that it's not going to be as simple as A-B-C.
A California healthcare system recently became the latest dropout from the Pioneer Accountable Care Organization program, citing the fact that payments are not adjusted by region. Sharp HealthCare announced the move in its third-quarter financial report.
Certain Accountable Care Organizations would be able to send Medicare beneficiaries to a skilled nursing facility without a prior hospital stay under a bipartisan bill recently introduced in the House of Representatives.
The Pioneer Accountable Care Organization program is now down to 19 programs, out of an original 32, worrying those who have pushed for skilled nursing facilities to embrace the concept.
A widespread lack of interoperable technology threatens the Accountable Care Organization model, according to recently released survey results.
The seeds that have flowered into the burgeoning of ACOs - groups of providers accepting the responsibility, and risk, for caring for the health of a designated patient population according to defined quality benchmarks (CMS measures quality of care using 33 measures in four key domains) - was planted long ago, in the baby boom.
SNF providers are scrambling to prepare to be "bought" by ACOs, aligned with potential bundling partners, selected as a preferred provider, and ultimately "sold" to the best, not highest, bidder.
Well-designed programs to coordinate care for patients with complex needs can reduce Medicare expenditures, including skilled nursing facility costs, according to an issue brief released Thursday by The Commonwealth Fund.
Accountable care organizations should be assessed on which patients bounce back to a member hospital within 30 days of being discharged to a skilled nursing facility, the Centers for Medicare & Medicaid Services asserts in a proposed rule.
The Medicare trust fund is on track to remain solvent until 2030, trustees of the program stated in a Congressional report released Monday. This improved outlook is due in part to revised expectations about the case mix in skilled nursing facilities.
In post-acute care, particularly the SNF future, it can be "Great" but there are so many "Perhaps" that the definition of what "Great" is going to be is unclear.
Skilled nursing facility readmissions should be an ACO quality measure, government proposes in payment ruleJuly 08, 2014
Accountable care organizations should be assessed on the number of people who return to a member hospital within 30 days of being discharged to a skilled nursing facility, the Centers for Medicare & Medicaid Services has stated in a proposed rule.
For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.
All ACOs should be allowed to waive 3-midnight requirement for Medicare skilled nursing coverage, MedPAC saysJune 18, 2014
Accountable care organizations should be able to place patients in skilled nursing facilities more quickly and communicate which SNFs are preferred providers, the Medicare Payment Advisory Commission stated in a letter to a top government health official.
Whether you're a long-term care leader who has already made the decision to align your organization with an ACO or are still in the process of weighing the decision, one thing everyone can agree on is this operating model will entail a significant amount of change in several key areas for participating long-term care providers.
Long-term care providers are participating in 'most ambitious test' of bundled payments, CMS announcesJanuary 31, 2014
Skilled nursing facilities and home health agencies are among 232 healthcare providers that have entered into agreements to take part in the Bundled Payments for Care Improvement initiative, the Centers for Medicare & Medicaid Services announced Thursday.
Skilled nursing and rehabilitation providers would be able to join networks dedicated to treating chronically ill Medicare patients, under a new bipartisan bill introduced Wednesday in both houses of Congress. The "Better Care, Lower Cost Act" seeks to establish the Better Care Program, which would enable healthcare providers to form networks similar to accountable care organizations, but with a special focus on coordinating care for those with chronic conditions.
In the early days of hospitalist medicine, we described the period between hospital discharge and follow-up at the skilled nursing facility, long-term care acute care hospital or a primary care physician as the infamous "Black Hole.
Nursing homes and other post-acute providers should position themselves now as top-tier candidates for accountable care organizations, or they risk losing significant market share, experts said in a McKnight's webcast yesterday.
Outcome assessment should be seen as a tool for change management and will likely become the new standard for assessing resident care under the Affordable Care Act.
By negotiating now, a nursing home can have a strong voice in an Accountable Care Organization. Otherwise, ACOs will come to nursing homes in two or three years with a "take it or leave it" proposition, according to John Durso, a partner at the law firm of Ungaretti & Harris LLP and a McKnight's Expert columnist.
Skilled nursing facilities that delay joining an Accountable Care Organization will likely be losers in the healthcare marketplace, according to John Durso, a partner at the law firm of Ungaretti & Harris LLP. Durso recently offered tips for nursing homes that are negotiating to join an integrated care network.
Post-acute care providers should be considering creative joint ventures with hospitals to best take advantage of evolving healthcare delivery and payment systems, healthcare finance and legal experts said Wednesday in an Avalere Health webcast.
The Centers for Medicare & Medicaid Services will be hosting a national conference call on Tuesday for providers interested in applying to take part in the Medicare Shared Savings Program. The 90-minute session starts at 1:30 p.m. Eastern. The Shared Savings Program is designed to help provides take part in Accountable Care Organizations (ACOs). On Tuesday, experts will offer tips on completing a successful MSS Program application, and more info on ACOs.
A four-person review panel would have to approve civil malpractice lawsuits against long-term care providers before the claims could go to court, under a bill that recently passed the state senate in Kentucky.
The current fee-for-service healthcare model should be replaced with bundled payment systems that encourage more coordinated care, the National Commission on Physician Payment Reform said in a report released Monday.
Increased coordination among acute and post-acute providers has reduced rehospitalization rates, signaling that healthcare reform is working, a senior Medicare official told the Senate Finance Committee on Feb. 28.
The Department of Health and Human Services will award $285 million for 25 states to innovate healthcare delivery and payment systems, the agency announced on Feb. 21. In many of these states, long-term care providers will take part in newly established multi-payer groups, such as accountable care organizations.
Accountable care organizations and bundled payment initiatives are harbingers of the future healthcare system in the United States, Health and Human Services Secretary Kathleen Sebelius said in a speech on Tuesday. Sebelius addressed the American Medical Association National Advocacy Conference in Washington, D.C.
Healthcare providers are increasing coordination to reduce the cost of care, but overly zealous consolidation can actually end up costing more, an expert panelist said at a Monday briefing.