Accountable Care Organizations

News & Analysis as of

CMS Releases MSSP and Pioneer ACO Data on Shared Savings and Losses – Where Do We Go From Here?

On September 16, 2014, the Centers for Medicare & Medicaid Services (CMS) announced key shared savings and losses results of Accountable Care Organizations (ACOs) that began participating in the Medicare Shared Savings...more

Another Pioneer Leaves The West

Another withdrawal from the Medicare Pioneer Accountable Care Organization (ACO) program has occurred. Sharp Healthcare ACO, an affiliate of the Sharp integrated delivery system in San Diego, California, notified the Center...more

Health Care Reform Implementation Update August 2014

The Centers for Medicare and Medicaid Services (CMS) made announcements this week regarding the Open Payments system and the availability of Affordable Care Act (ACA) Consumer Assistance Program grant funds, issued a request...more

Health Update - August 2014 #5

The Five Megatrends Shaping Pharma’s Next Decade: Sustaining Success in a New Market Landscape - Disruptive trends in the healthcare system will force companies to change their strategies. With new care models...more

The Reformed Health Care Industry: Creative Structures and Alliances Can Yield Great Benefits, but Also Great Risks

Since the Affordable Care Act (the “ACA”) was enacted in 2010, the health care industry has been on the edge of its proverbial seat waiting to see which care delivery models are best suited to sustain all the changes: to...more

CMS and ACOs: A Busy Summer and a Busier Fall

It has been a busy summer so far for the Centers for Medicare & Medicaid Services (CMS) with respect to Accountable Care Organizations (ACOs), as the agency has proposed altering the quality reporting measures under the...more

ACOs And Pay for Value … About the Data

It has been over three years since the Centers for Medicare and Medicaid Services (CMS) announced its proposed rule and guidance on the development and implementation of Accountable Care Organizations. About four million...more

Health Update - July 2014

Avoiding the Regulatory Land Mines of Commercial ACOs - While providers are showing great interest in creating ACOs to participate in the Medicare Shared Savings Program (MSSP), they are showing even greater enthusiasm...more

Anatomy of an Independent Primary Care ACO – Part II

Our Secret Weapon and Our Biggest Disappointment - In our last column, we highlighted the Rio Grande Valley Health Alliance, an accountable care organization in McAllen, Tex., composed of 14 independent primary care...more

Anatomy of an Independent Primary Care ACO, Part I

While concepts and theories can go a long way, sometimes the best way to understand something is through a concrete example. So, from time to time, ACO Insider will check in on a new accountable care organization composed of...more

Five Steps to Becoming a Primary Care Leader

With ever more data demonstrating that patient-centered medical homes are the core of successful Accountable Care Organizations (ACO), it’s becoming clear that primary care physicians can have a meaningful role in the...more

The ACA’s Bumpy Ride

From the monumental failure of the initial government website for the federal health insurance marketplace (healthcare.gov) to the looming employer mandate, the Affordable Care Act has garnered its fair share of criticism....more

Health Care Reform Implementation Update - July 2014

On June 30, in one of the most highly anticipated cases affecting the Affordable Care Act (ACA), the Supreme Court ruled that closely held companies could assert a “religious objection” to the ACA contraceptive coverage...more

Health Headlines: Also in the News - July 2014

New ACO Rules Sent to OMB for Review – On June 26, 2014, a proposed Accountable Care Organization (ACO) rule that would make changes to the Medicare Shared Savings Program in advance of the second round of ACO contracts...more

Health Headlines: Also in the News - June 2014 #3

MedPAC Recommends Short- and Long-Term ACO Changes – In a comment letter sent to CMS Administrator Marilyn Tavenner on June 16, 2014, the Medicare Payment Advisory Commission (MedPAC) outlined certain challenges associated...more

Antitrust and Health Care: An Update from the Federal Trade Commission

The interplay between the Affordable Care Act (ACA), Accountable Care Organizations (ACOs), and antitrust has been a matter of great moment for several years. It has been an issue in litigation such as the Federal Trade...more

A “virtual merger” is underway between Chicago-area Alexian Brothers Health System and Adventist Midwest Health

Chicago-area Alexian Brothers Health System and Adventist Midwest Health signed a non-binding letter of intent to form a joint operating company, a collaboration commonly referred to as a virtual merger. As Alexian brings...more

Confidentiality of Substance Abuse Treatment Information: HHS Considers Changes to the Part 2 Regulations and Requests Comment

The Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) is considering significant changes to the “Part 2” regulations (the Confidentiality of Alcohol and Drug Abuse...more

Health Care in 2014: A Brave New World

With the completion of the enrollment phase of the Affordable Care Act (ACA), health care in the United States has entered a new era that will be characterized by extensive changes and challenges for both providers and...more

American Hospital Association Recommends Revisions to Medicare ACO Models

The American Hospital Association (AHA) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) on April 17, 2014, recommending modifications to the Medicare Shared Savings Program (MSSP) and the Pioneer...more

Tax Developments Affecting Health Care Organizations and Investor-Owned Hospital Companies [Video]

Several Treasury regulations, revenue procedures, and other developments have recently been released, which may have important consequences for businesses, including health care organizations. Moreover, changes in regulatory...more

Five Key Decisions for ACOs Looking to Participate in the 2015 MSSP

The Centers for Medicare & Medicaid Services (CMS) has announced the upcoming deadlines for the third round of new applications to the Medicare Shared Savings Program (MSSP). Accountable Care Organizations (ACOs) that...more

FTC Hosts Public Workshop, “Examining Health Care Competition”

During the last several years, the Federal Trade Commission (FTC) has taken an active role in antitrust enforcement in the health care industry, particularly with respect to hospital and physician group acquisitions. Last...more

CMS Releases Information on Success of Shared Savings Programs: Early Results Mixed and Inconclusive

On January 30, 2014, CMS released results on the Medicare Shared Savings Program (“MSSP”) and the Pioneer Accountable Care Organization Program (“Pioneer ACO Program”) for 2012, the initial performance year of each program....more

ACOs Show Some Savings Potential: Legislative and Regulatory Initiatives Ramping Up

The evolution of Accountable Care Organizations (ACOs) will be a big factor this year as the Obama Administration continues to focus on curbing health care spending and Congress ramps up its efforts to address physician...more

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