Part B News

01 July 2016

In the wake of the final Shared Savings rule, health care professionals are anticipating an easier road to success for accountable care organizations (ACOs) in the Medicare Shared Savings Program. Under the rule, new entrants’ performance will be compared not to nationwide scores, but to their Medicare fee-for-service peers in the counties where their patients live. The change means providers in high-cost markets like Miami will no longer be penalized for being unable to meet benchmarks set in lower-cost markets like North Dakota.

Jim Giordano, national director of value-based care and population health management services at Kurt Salmon, believes the incentive should drive physicians and their patient panels into ACOs. But having them stay through the move from one-sided to two-sided risk is another question. “The non-performing majority of ACOs must develop the infrastructure and workflows to successfully manage care delivery under value-based initiatives,” says Giordano. “If these ACOs cannot successfully provide value to their network of providers and assist them to be successful in managing their beneficiary population, there will be very little to hold the physician in the ACO as a participating provider.”

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