- Considerations regarding the Next Generation ACO stop-loss methodology
By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 22 December 2017
This report identifies several important considerations regarding the impact of the stop-loss provision on participating Next Generation accountable care organizations.
- Individual stop-loss is now optional for Next Generation ACOs
By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 08 November 2017
For some Next Generation Accountable Care Organizations, the choice between an annual financial reconciliation based upon capped claims or uncapped claims could have a significant impact.
- Next Generation ACO Program financial results for 2016
By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 08 November 2017
This paper describes the financial results of the Next Generation Accountable Care Organizations program.
- What predictive analytics can tell us about key drivers of MSSP results
By Jill S. Herbold, Anders Larson, Cory Gusland | 28 September 2017
This article provides insight into the 2015 gross savings/(losses) achieved by accountable care organizations in their third performance year of the Medicare Shared Savings Program.
- Telehealth under alternative payment models
By Susan Philip | 13 September 2017
Telehealth has the potential to boost the impact of population health management initiatives while improving access and convenience of healthcare delivery.
- Regulatory capital strategies in an evolving health insurance landscape
By David M. Liner | 30 August 2017
As the relationship between health plans and healthcare providers continues to evolve, this landscape creates new financial opportunities for health plans managing regulatory capital.
- Performance of skilled nursing facilities for the Medicare population
By Anders Larson, Jill S. Herbold | 09 December 2016
This report discusses a framework and metrics for measuring skilled nursing facility (SNF) performance, explores SNF performance levels across the United States, and provides a quantitative assessment of the opportunity to reduce spending for SNF services through steerage of patients to more cost-efficient SNFs.
- Five common pitfalls in commercial ACO shared risk arrangements
By Adam Laurin, Cory Gusland | 31 August 2016
For shared risk agreements to be transformational, providers and payers must work together to construct agreements that adequately reward providers, are economically viable over a multiyear period, and strive to transfer care management risk.
- Next Generation ACO Model: Should we take the plunge?
By Charlie Mills, Cory Gusland, Noah Champagne | 31 March 2016
This article identifies five key considerations that all accountable care organizations (ACOs) should closely review before deciding whether or not to use the Next Generation ACO Model.
- The essential eight: Keys to successful ACO contracting
By Kimberley K. Hiemenz | 15 October 2015
This article discusses common elements critical to analyzing and understanding shared risk and population-based arrangements.