Medicare Shared Savings Program Shines Spotlight on ACOs

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Medicare Shared Savings Program Shines Spotlight on ACOs

It appears that accountable care organizations (ACOs), patient-centered medical homes and other care models that stress value and quality over fee for service aren’t going anywhere.

One of the newest efforts to promote ACOs comes from the Centers for Medicare & Medicaid Services. The agency announced that it is making $114 million available to encourage organizations in rural and underserved areas to take on more financial risk. The new ACO Investment Model will provide upfront investments to as many as 75 ACOs.

The deadline has passed for entities that participated in the Medicare Shared Savings Program in 2012 and 2013. Organizations that participated in 2014 or are interested in beginning participation should watch out for applications during summer 2015.

If your organization hasn’t thought about participating in an ACO yet, this could be your opportunity. We know the valuable role that home care plays in the care continuum. By visiting patients in their homes or monitoring them remotely, we gain valuable insight into their health, medication adherence, mood and willingness to participate in their own care.

We often recognize problems before they turn into hospital admissions or readmissions and can call in the necessary interventions to keep patients at home. But it’s not enough for homecare executives to express a willingness to participate in any collaborative care model. You must know your cost structure and your outcomes – two areas where agency and clinical management software can help.

Pioneer ACOs have made headlines in recent months. Thirteen of the original 32 Pioneer ACOs have dropped out of the Medicare Shared Savings Program, raising questions about its future viability. However, a report detailing the program’s first two years shows that Pioneer ACOs decreased Medicare spending by $817 million. It’s not surprising to learn that costs went up at some ACOs and that quality scores varied widely.

Whether you currently are participating in an ACO or are looking to do so, don’t let this mixed bag of news about Pioneer ACOs discourage your organization from looking at new ways to care for patients or finding care partners.

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