Our Latest Thinking

We are constantly scanning the health care market for new and interesting developments; then we write about them here. Check out our latest thinking.

Medicare

Analysis of 52 PAC Trends

November 28th, 2016

PAC represents the next frontier of opportunity for the success of ACOs, BPCI Model 2 participants, and CJR hospitals. In fact, of the ACOs which achieved shared savings, most attribute their success to closer PAC care coordination. Hospitals are narrowing networks, wanting to find the best PAC partners possible, and stronger care pathways and coordination are taking place at unprecedented levels.

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The Cost of Quality: How Star Ratings Can Influence Monthly Premiums in Medicare Advantage Plans

November 14th, 2016

The Centers for Medicare and Medicaid Services assigns a star rating to Medicare Advantage plans to help beneficiaries better understand and select their insurance plan.

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Medicare Advantage: CMS’ First Step into Value Based Care is Now Coming Full Circle

September 1st, 2016

Medicare Advantage (MA) offers Medicare benefits through private health plans, providing an alternative to the traditional, federally-administered program. Also known as Medicare Part C, this private option traces its roots to the 1970s and received its current name and form in the Medicare Modernization Act of 2003. Since then, the number of enrollees has grown […]

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CMS Proposes New Mandatory Bundled Payment Models: 4 Observations

July 29th, 2016

On July 25, 2016, CMS announced a proposed rule to provide additional incentives for hospitals to provide higher quality care at a lower cost. The proposed rule seeks to increase coordination of care and decrease costs for heart attack and bypass surgery patients, creates a new Surgical Hip/Femur Fracture Treatment model (SHFFT), and outlines a […]

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LP Data Insight: Medicare Spend by Service Type and Beneficiary Age

June 14th, 2016

Using CMS Limited Data Set (LDS) 2013 claims data, I examined the distribution of all Medicare fee-for-service (FFS) costs. The LDS claims file consist of 100% of all FFS claims for inpatient, outpatient, home health, skilled nursing facilities (SNF), and hospice. However, they include only a 5% sample for claims related to durable medical equipment […]

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Ten Early Takeaways from the Medicare Shared Savings ACO Program

April 5th, 2016

Using a combination of public and proprietary data, Leavitt Partners analyzed MSSP results and identified ten key takeaways.

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MSSP ACOs: Financial Savings and the Appetite for More

March 2nd, 2016

CMS’ January 11 announcement of the new and renewing Medicare ACO participants indicated both an increase in the number of ACOs and ACO covered lives.

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A Taxonomy of Accountable Care Organizations: Different Approaches to Achieve the Triple Aim

June 16th, 2014

As providers begin to bear risk for defined populations, providers and payers have begun to change the way they deliver and pay for health care. Accountable care organizations (ACOs), in particular, have proliferated with the common goal to fulfill the triple aim of improved patient satisfaction, improved care and decreased health care costs. Though ACOs […]

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