As per reliable sources close to healthcare sector, the Centre for Medicare and Medicaid services has released the annual result for ACOs or accountable care organizations in the Medicare’s Shared Savings program. This is the second ACO model and this program works along the same lines to the Pioneer program and medical billing and coding companies with less risky financial plans as an added benefit.
This Shared Savings Program comprises of 220 ACOs and among them, almost 53 organizations spend around 652 million dollars less than their estimated targets. Also, these medical billing and coding companies earned in excess of 300 million dollars as performance payments, which further emphasizes on the less risky financial plans involved in this program. Reports also stated that around 52 additional ACOs compared their health costs to the benchmarks they had already set last year i.e. before the launch of the program, but found that they did not qualify for shared savings. However, among the remaining medical organizations, only one was reported to have financial loss.
As stated by Paul Reber, DO, St. Mary’s ACO medical director, “According to the CMS report, Medicare members in the Dean/St. Mary’s ACO have become healthier over time and our cost of care has remained well below the national average. However, due to the complex payment methodology in the Medicare Shared Savings Program, we were unable to meet all of the necessary benchmarks.”
One of the ACOs that slightly fared better in the Shared Savings Program had several other business units including a hospitalist business as well as an independent practice association that uses capitation. This enabled the physicians to take care of the patients within a fixed budget. Other medical billing and coding companies were not able to provide such facilities. The reports also suggested that ACOs in the Shared Savings Program improved overall on 30 of 33 measures that included health promotion and education as well as screening for tobacco use and cessation.
Well, it can be said that the ACOs has emphasized more on improving the healthcare facilities with the Shared Savings Program and the active participation of the medical billing and coding companies. Commenting on this, Paul Reber also said that, “It requires investment in services not traditionally offered, such as Care Management, Transitions of Care, Coordination of Care, and Home Health Services. Dean and St. Mary’s are proud that we have demonstrated improved health outcomes at no additional cost.”