Rural Health
Resources by Topic: Accountable Care Organizations
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
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April 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Hospital Participation in Medicare Accountable Care Organizations
Report explores the rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Details some of the factors that correspond to participation and compares rates by region and by rural status.
Date: 04/2020
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Report explores the rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Details some of the factors that correspond to participation and compares rates by region and by rural status.
Date: 04/2020
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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How to Better Support Small Physician-led Accountable Care Organizations: Recent Program Updates, Challenges, and Policy Implications
Describes the strategies of successful small physician-led Accountable Care Organizations (ACOs). Discusses how policy changes contribute to the opportunities and challenges for these ACOs. Explores how "ACO Enablers" aid small ACOs in participating in risk-bearing models. Includes a brief discussion of how the ACO Investment Model program supported ACOs in rural and underserved areas with access to capital.
Author(s): Jonathan Gonzalez-Smith, Hannah Crook, Elizabeth Singletary, William Bleser, Robert Saunders
Date: 02/2020
Sponsoring organizations: Duke Margolis Center for Health Policy, Robert Wood Johnson Foundation
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Describes the strategies of successful small physician-led Accountable Care Organizations (ACOs). Discusses how policy changes contribute to the opportunities and challenges for these ACOs. Explores how "ACO Enablers" aid small ACOs in participating in risk-bearing models. Includes a brief discussion of how the ACO Investment Model program supported ACOs in rural and underserved areas with access to capital.
Author(s): Jonathan Gonzalez-Smith, Hannah Crook, Elizabeth Singletary, William Bleser, Robert Saunders
Date: 02/2020
Sponsoring organizations: Duke Margolis Center for Health Policy, Robert Wood Johnson Foundation
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Second Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on the impact of the Next Generation Accountable Care Organization model in 2016 and 2017, with information on the full sample of 46 participating NGACOs. Provides information on the models' impact on gross and net Medicare spending. The appendices include data on community characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2020
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Reports on the impact of the Next Generation Accountable Care Organization model in 2016 and 2017, with information on the full sample of 46 participating NGACOs. Provides information on the models' impact on gross and net Medicare spending. The appendices include data on community characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2020
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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The Rural Health Care Coordination Network Partnership Program: South East Rural Physicians Alliance
Describes and examines the impact of a care coordination program developed by the South East Rural Physicians Alliance-Independent Physician Association located in Nebraska. Program focuses on clinic-based care coordination for high-risk patients with diagnosed diabetes or congestive heart failure. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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Describes and examines the impact of a care coordination program developed by the South East Rural Physicians Alliance-Independent Physician Association located in Nebraska. Program focuses on clinic-based care coordination for high-risk patients with diagnosed diabetes or congestive heart failure. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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Evaluation of the Accountable Care Organization Investment Model: AIM Implementation and Impacts over Two Performance Years
Evaluation examining the first two years of the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Reports on AIM ACO composition, including rurality. Appendices include detailed information on each AIM ACO.
Additional links: Appendices, Findings at a Glance
Date: 09/2019
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Evaluation examining the first two years of the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Reports on AIM ACO composition, including rurality. Appendices include detailed information on each AIM ACO.
Additional links: Appendices, Findings at a Glance
Date: 09/2019
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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Accelerating Value-Based Payment in California's Federally Qualified Health Centers: Options for Medicaid Health Plans
Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Sponsoring organization: Center for Health Care Strategies
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Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Sponsoring organization: Center for Health Care Strategies
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ACOs' Strategies for Transitioning to Value-Based Care: Lessons From the Medicare Shared Savings Program
Describes strategies used by successful Accountable Care Organizations (ACOs) to reduce spending and increase healthcare quality. Addresses social determinants of health, behavioral health, reducing hospitalizations, using technology to share information, and more. Two of the 20 ACOs included in the study served rural communities.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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Describes strategies used by successful Accountable Care Organizations (ACOs) to reduce spending and increase healthcare quality. Addresses social determinants of health, behavioral health, reducing hospitalizations, using technology to share information, and more. Two of the 20 ACOs included in the study served rural communities.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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