News Clips
Revcycle Intelligence: (3/29) - The Southwestern Health Resources Accountable Care Network, which is one of the nation’s top-performing Next Generation ACOs, saved over $52 million in 2019, accounting for a fifth of total program savings that year and bringing individual ACO savings to $120 million since 2017. Leaders at Southwestern Health Resources attribute this success to physician-driven strategies and are using technology to redesign the physician referral process to prevent out-of-network utilization that can impact care coordination and overall success.
PitchBook: (3/26) - In its new analyst note, PitchBook outlines the potential impact that value-based care can have on emerging technology and health care at large. Highlights of the report include that Medicare will be the primary driver of value-based care models and will boost investment in technology to treat conditions common among Medicare patients.
Kaiser Health News: (3/26) - According to research from Health Affairs, facility fees are a major reason why hospital prices are rising faster than physician prices. Patients like Kyunghee Lee, who experienced a price hike that was ten times what she had traditionally paid for pain-relieving steroid injections for arthritis, are often left with the price increases, even if for the same service in the same physician office as previously rendered. Site-neutral payment policies, like what CMS has introduced, are important to curtailing facility fees to protect patients.
Bloomberg Law: (3/25) - Consolidation of physician practices is expected to grow due to the strain caused by sharp reductions in patient visits that many independent physician practices have experienced during the pandemic. As of February, physician services was one of the top five sectors for health care transactions, with 71 deals involving over a dozen physician specialties having occurred, including 16 for primary care practices. The pandemic, increased competition, and reimbursement changes continue to cause uncertainty in the health care landscape.
Health Payer Intelligence: (3/25) - A recent study in JAMA Network Open revealed that Medicare Advantage (MA) plans matched or fell below traditional Medicare’s record on 13 low-value care measures, despite payers claiming MA plans’ capacity to reduce low-value care spending for seniors. One strategy payers can use to reduce low-value care includes employing alternative payment models that incentivize value-based care, so that reimbursement for low-value services can be excluded.
Revcycle Intelligence: (3/25) - The National Association of Accountable Care Organizations (NAACOS) recently sent a letter to HHS Secretary Xavier Becerra recommending that HHS promote significant ACO growth to continue the movement toward value-based care. President and CEO Clif Gaus, ScD, outlined the cost-saving impact ACOs have had on Medicare spending and encouraged HHS to set a national goal for the majority of traditional Medicare beneficiaries in an ACO by 2025.
Johns Hopkins University: (3/23) - Regulatory changes, revised payment models, and increased private equity investments over the last decade have all led to increased consolidation in the health care industry. Health Economist Daniel Polosky has noted that private equity purchases of physician practices can reduce competition in the market and raise prices without making improvements to health care quality. He calls for transparency across the industry so watchful regulators can take action as needed.
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