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  • 'Flurry of Activity' Around Shared Savings, Says Commonwealth Issue Brief

    A new issue brief released this week by the Commonwealth Fund highlights several diverse approaches to shared-savings arrangements, including the populations and services covered, the assignment of providers, the use of risk adjustment, and the way savings are calculated and distributed. The brief also identifies issues payers and providers must resolve going forward, such as determining whether savings were achieved, equipping providers with necessary tools and technical advice, agreeing upon standard performance measures, and refining the model over time.

    Shared-savings arrangements have "attracted great interest, in part fueled by Affordable Care Act provisions that create accountable care organizations and by the movement among medical home pilots to make payment methodologies more performance-based," say the authors. "The current flurry of activity is sparking cre­ativity and the opportunity to try different approaches."   

    For this brief, the authors conducted 32 tele­phone interviews with payer and provider organiza­tions and state agency agencies that indicated they were involved in 27 independent past, current, and planned shared-savings payment arrangements.


    • ACOs have "incentives for providers to reduce healthcare spending" by giving the ACO a percentage of those net savings. This could easily mean cutting out referal to PT. Doctors who once referred to outpatient clinics will now be "encouraged" not to? Reduce spending means reduced care. Docs can't reduce tests for fear of lawsuits. I worry about the ACO not referring a patient for PT to achieve the savings that makes more money for the ACO. Non-referral for profit?

      Posted by Debbe Klaja on 8/19/2011 5:19 PM

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