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The Centers for Medicare & Medicaid Services (CMS) recently made three significant announcements, signaling a strong commitment to continuing value-based care delivery initiatives.
First, we learned that 124 groups of providers recently joined the Medicare Shared Savings Program (MSSP) or its Track 1+ accountable care organization (ACO) model, fostering a large uptick in Medicare ACO participation. CMS also announced the launch of the Bundled Payments for Care Improvement (BPCI) Advanced model as its next generation voluntary bundled payment program to build on the progress made under the BPCI program. Additionally, the agency highlighted 14 new Next Generation ACOs.
What’s more, providers that participate in the BPCI Advanced, the MSSP Track 1+ model and the Next Generation ACO model will likely qualify as Advanced Alternative Payment Models (Advanced APMs), meaning clinicians are eligible for the five percent Medicare payment bonus in 2021 under the Quality Payment Program, as long as they meet the threshold for patients or revenue going through the model. These shifts are creating additional incentives for doctors and hospitals to participate in value-based payment models that require them to accept two-sided risk.
With $2 billion in savings generated by Medicare ACOs, and CMS realizing savings through their bundled payment programs, value-based models are proving to be successful in achieving both patient-centric and cost-effective care. In fact, we have found that effective APMs can generate increased savings and quality improvement – Premier Population Health Management Collaborative member Medicare ACOs have consistently performed 2X better than all other Medicare ACOs since 2012 and Premier Bundled Payment Collaborative members in the Comprehensive Joint Replacement (CJR) model are performing 35 percent better than their peers.
Staying ahead of this shift toward value-based payment and risk-sharing is becoming increasingly important. ACO and bundled payment models can be a powerful means to increase revenue, manage costs and get better reimbursement, as well as achieve highly reliable care.
Below are three key strategies your organization should consider to enable success within alternative payment models:
Want to learn more about your options to survive in today and tomorrow’s value-based, risk-sharing environment? Contact Seth Edwards regarding Accountable Care Organizations and the Medicare Shared Savings Program or Mark Hiller on Bundled Payments.