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Blog posts tagged with ACO

  • Improving pneumococcal vaccination rates

    Jennifer Bolduc MD
    February 07, 2017

    With the number of clinical quality measures required today, there is an abundance of data. But what should we do with all of this information? I ran across a recent example of a data-driven initiative that was both simple and effective. It’s a collaborative health-improvement model (funded by a grant from Pfizer), and it focused on increasing pneumococcal vaccination rates. And it worked beautifully. Read more…

  • Right-sized care: acute intervention in an ambulatory setting

    Jennifer Bolduc MD
    January 24, 2017

    As a pediatrician, I find that there are times when my patients require a specific acute intervention – but they don’t need the full hospital experience. Outpatient clinics face many scenarios when an intermediary care setting would be ideal. Holston Medical Group (HMG), a large multi-specialty physician group based in Kingsport, Tennessee, U.S.A., has developed its own response to this challenge: The Extensivist Clinic. Read more…

  • The good news, bad news of recent ACO results

    Mike Hofmeister
    August 27, 2015

    This week, the Centers for Medicare & Medicaid Services announced 2014 results for 333 Medicare Accountable Care Organizations (ACOs). It’s pretty exciting news; 56% of ACOs reduced costs and improved quality measures and reporting, which is up from 40% in previous years. The downside of the report is that only 29% of ACOs participated in shared savings, which is simply not enough. The ACOs are saving money, but they’re not earning revenue at the same rate. It’s clear that we, as Read more…

  • Unlocking the mysteries within your CMS claim file

    Mike Hofmeister
    May 12, 2015

    In a healthcare industry that is shifting from fee-for-service to value-based-care models, it’s increasingly important for practices to understand everything about their costs. To that end, Centers for Medicare and Medicaid Services (CMS) delivers a claim file to Accountable Care Organizations (ACOs). Unfortunately, ACOs often don’t take full advantage of the intelligence available within the CMS claim file. But if ACOs can unlock these “mysteries” held within the file, they can reduce costs more quickly. Here are just a few examples: Read more…

  • An ACO rookie’s most common mistake

    Mike Hofmeister
    February 26, 2015

    To stay competitive in an evolving healthcare landscape, independent small physician practices are creating their own Accountable Care Organizations (ACO). It’s important for them to have accurate expectations before applying to Center for Medicare & Medicaid Services (CMS) and its Shared Savings Program. Unfortunately, new ACO applicants often miscalculate the number of CMS patients, or “attributed lives,” they are responsible for, putting their entire cost structure at risk. Read more…

  • Finding tomorrow’s high-risk patients

    Mike Hofmeister
    February 04, 2015

    As the healthcare industry offers more ways to earn risk-based or value-based revenue, providers are more proactively coordinating care, engaging patients and managing population health. Analytics are fundamental to all of these strategies, even in small practices. To be successful, physician practices need analytics that are predictive across multiple populations. They need to know who the high-risk patients are today, but they also need to identify the “rising-risk” patients. With Read more…

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