Medicare’s ACO Program, Which Offers Doctors, Hospitals Rewards For Better Care, Saved $740M Last Year
The program, initiated under the Affordable Care Act, is designed to reward top-performing health providers with bonuses while pushing those that do poorly to repay Medicare. In her announcement, Seema Verma, the head of the Centers for Medicare & Medicaid Services, said nearly 11 million Medicare beneficiaries are served by an accountable care organization. Other Medicare news includes the penalties hospitals face for having too many readmissions.
Verma Touts ACO Savings
Medicare's flagship accountable care organization program generated nearly $740 million in net savings last year, CMS Administrator Seema Verma announced this afternoon. Nearly 11 million Medicare fee-for-service beneficiaries were receiving care through an ACO as of July 2019, representing an uptick of 400,000 since last year, she added in a Health Affairs blog post about Medicare's Shared Savings Program. Verma, a former critic of the Obama-era program, touted recent changes that she said would lead to higher-quality, more efficient care. (Diamond, 9/30)
Kaiser Health News:
New Round Of Medicare Readmission Penalties Hits 2,583 Hospitals
Medicare cut payments to 2,583 hospitals Tuesday, continuing the Affordable Care Act’s eight-year campaign to financially pressure hospitals into reducing the number of patients who return for a second stay within a month. The severity and broad application of the penalties, which Medicare estimates will cost hospitals $563 million over a year, follows the trend of the past few years. Of the 3,129 general hospitals evaluated in the Hospital Readmission Reduction Program, 83% received a penalty, which will be deducted from each payment for a Medicare patient stay over the fiscal year that begins today. (Rau, 10/1)
Kaiser Health News:
Look Up Your Hospital: Is It Being Penalized By Medicare?
Each year, Medicare punishes hospitals that have high rates of readmissions and high rates of infections and patient injuries. Check out which hospitals have been penalized. (10/1)
Hospital, Insurers Oppose Forced Disclosure Of Negotiated Prices
Hospitals and health insurers may not see eye to eye on a lot, but they do agree that the federal government's proposal to make hospitals publicly post payer-negotiated rates for medical services would be bad for business and patients. In comments on the hospital outpatient prospective payment proposed rule, which were due Friday, they urged the CMS to abandon the plan. (Livingston, 9/30)
CMS To Allow States To Offer Individual Market Wellness Programs
The CMS has launched a pilot project for states to implement health-contingent wellness programs in the individual market. The states will be able to offer residents lower premiums or other incentives if they choose to participate in the state's wellness program through the individual market. The CMS is currently seeking applications for the project, which will involve 10 states. (Castellucci, 9/30)