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Medicare Shared Savings Program
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in A Decade of ACOs in Medicare: Have They Delivered on Their Promise?
> Journal of Health Politics, Policy and Law
Published: 01 February 2023
Figure 1 Number of MSSP ACOs and percentage assuming one- or two-sided risk (2012–2022). Notes : MSSP = Medicare Shared Savings Program; ACO = accountable care organization. Data are derived from CMS's Fast Facts documents, accessible at https://www.cms.gov/files/document/2022-shared-savings
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Journal Article
J Health Polit Policy Law (2014) 39 (6): 1185–1211.
Published: 01 December 2014
.... Initiatives like the New Jersey Medicaid ACO Demonstration and the Medicare Shared Savings Program will not return savings stemming from improved care for the uninsured high users, yet, as noted, helping finance such efforts may well be in hospitals' interest. In spite of incentives shifting in favor...
Includes: Supplementary data
Journal Article
J Health Polit Policy Law (2023) 48 (1): 63–92.
Published: 01 February 2023
...Figure 1 Number of MSSP ACOs and percentage assuming one- or two-sided risk (2012–2022). Notes : MSSP = Medicare Shared Savings Program; ACO = accountable care organization. Data are derived from CMS's Fast Facts documents, accessible at https://www.cms.gov/files/document/2022-shared-savings...
FIGURES
Journal Article
J Health Polit Policy Law (2015) 40 (4): 839–846.
Published: 01 August 2015
... — the Final Rule for the Medicare Shared Savings Program .” New England Journal of Medicine 365 , no. 19 : 1753 – 56 . Burns Lawton R. , and Pauly Mark V. 2012 . “ Accountable Care Organizations May Have Difficulty Avoiding the Failures of Integrated Delivery Networks of the 1990s...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 875–886.
Published: 01 August 2015
... for, and participates in, the Shared Savings Program (SSP) established by the Centers for Medicare and Medicaid Services (CMS) and (2) uses the same governance and leadership structures and clinical and administrative processes it uses in the SSP to serve patients in commercial markets. The federal antitrust agencies...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 897–903.
Published: 01 August 2015
... (unwisely in my view [Greaney 2013a ]) from requiring preclearance from the antitrust agencies for ACOs applying to participate in the Medicare Shared Savings Program, CMS's final rule implementing the program pledged cooperation among the agencies to facilitate monitoring of competitive issues...
Journal Article
J Health Polit Policy Law (2016) 41 (4): 743–762.
Published: 01 August 2016
..., covering 38 percent of residents in commercial health plans and 61 percent of those in Medicare Advantage (CHIA 2016 ). In 2012 five Massachusetts health systems joined Medicare's Pioneer ACO program, and by 2013 fourteen more groups joined the Medicare Shared Savings Program. The state passed legislation...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 745–760.
Published: 01 August 2015
...) to establish a shared savings program that promotes accountability for Medicare Parts A and B costs. To be eligible to receive payment for shared savings from Medicare, ACOs must meet quality performance standards and their risk-adjusted expenditure for a Medicare patient population of at least five thousand...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 711–744.
Published: 01 August 2015
.... Procompetition advocates have made a strong case for ACOs functioning in an environment of “integration and rivalry” (Greaney 2014 ). Indeed, CMS in its final rule for the Medicare Shared Savings Program (MSSP) that governs ACO start-ups overtly endorses the competition paradigm for ACOs by explicitly linking...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 847–874.
Published: 01 August 2015
... by two or more ACO participants to obtain clearance from either the FTC or the DOJ before the ACO could participate in the Medicare Shared Savings Program (FTC and DOJ 2011a ). This threshold made it likely that most ACO applicants would have been subject to mandatory FTC or DOJ review. The agencies...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 887–896.
Published: 01 August 2015
... David , and Satterthwaite Mark . 2003 . “ Competition and Market Demand in Option Demand Markets .” RAND Journal of Economics 34 , no. 4 : 737 – 63 . CMS (Centers for Medicare and Medicaid Services) . 2011 . “ Medicare Shared Savings Program for Accountable Care Organizations...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 821–837.
Published: 01 August 2015
... A. 2012 . “ Next Steps for ACOs .” Health Policy Brief, Health Affairs , January 31 . www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=61 . Berwick Donald . 2011 . “ Launching Accountable Care Organizations — the Proposed Rule for the Medicare Shared Savings Program .” New...
Journal Article
J Health Polit Policy Law (2016) 41 (6): 1119–1136.
Published: 01 December 2016
... improve as a result of Medicare's shared-savings program under which an ACO promises to care for a population of at least 5,000 Medicare beneficiaries without exceeding a total cost threshold set by Medicare (42 C.F.R. Part 425). In return, Medicare promises to share with an ACO any savings generated...
Journal Article
J Health Polit Policy Law (1988) 13 (1): 53–81.
Published: 01 February 1988
.... Thus, on the
one hand, Congress appears to be strongly rejecting increased cost sharing as an
approach to program savings. On the other hand, increased cost sharing would
still be available to help with Medicare’s future fiscal crunch, if need be.
In contrast to increased cost sharing...
Journal Article
J Health Polit Policy Law (2017) 42 (1): 53–71.
Published: 01 February 2017
... of forty-eight medical or surgical episodes with the opportunity for “gainsharing” by demonstration participants, that is, for sharing with the Medicare program any savings achieved. The most expansive model includes all services during hospitalization and for a period of thirty, sixty, or ninety days...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 761–796.
Published: 01 August 2015
... million in shared savings. Notably, only half were successful in exceeding the 2% benchmark, and one participant accounted for 50% of aggregate savings. Medicare Shared Savings Program (MSSP) Medicare — Accountable Care Organization (ACO) Demonstration ■ Must serve at least five thousand Medicare FFS...
FIGURES
Journal Article
J Health Polit Policy Law (2018) 43 (3): 401–425.
Published: 01 June 2018
... into payment: the Hospital Readmissions Reduction Program (HRRP), Hospital Value-Based Purchasing Program, Hospital-Acquired Condition Reduction Program, Medicare Advantage Quality Star Rating Program, Medicare Shared Savings Program, Physician Value-Based Payment Modifier Program, End-Stage Renal Disease...
FIGURES
Journal Article
J Health Polit Policy Law (2020) 45 (5): 889–904.
Published: 01 October 2020
... in the Medicare Shared Savings Program after Accounting for Nonrandom Exit: An Instrumental Variable Analysis .” Annals of Internal Medicine 171 , no. 1 : 27 – 36 . doi.org/10.7326/M18-2539 . McWilliams J. Michael , Landon Bruce , and Chernew Michael . 2013 . “ Changes in Health Care...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 669–688.
Published: 01 August 2015
... and the California commercial market, as well as ACOs that are emerging within Medi-Cal and the safety net. There are three models of ACOs within the Medicare fee-for-service program: (1) a permanent program known as the Medicare Shared Savings Program (MSSP); (2) the Medicare Advance Payment ACO Model...
FIGURES
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Journal Article
J Health Polit Policy Law (2014) 39 (4): 901–917.
Published: 01 August 2014
... Medicaid managed care enrollees. By the end of 2013 CHA expects to have global risk or shared savings contracts covering about half of its primary care patients, including six thousand seniors in the Medicare shared savings program. Its objective is to move the bulk of its primary care patients into global...
FIGURES
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