CER Daily Newsfeed

Will The New CMS ACO Model LEAD To Better Care For High-Need Medicare Beneficiaries?

(3/6, William D. J. Roberts, José F. Figueroa, Health Affairs Forefront) comments “...REACH attempted to operationalize equity through targeted payment adjustments and required planning. LEAD reframes the objective around high-need patients and participation flexibility. While this shift may expand engagement, it also risks diluting focus on disparities. Health inequities impose substantial national economic costs, including excess medical spending and lost productivity. Absent of deliberate measurement and accountability, value-based payment models do not inherently reduce inequities and may exacerbate them when benchmarks fail to capture social risk.” Full

Medicare’s Unrealized Opportunity: Using ACOs To Create Real Competition

(3/6, Bryan Dowd, Anthony T. LoSasso, Health Affairs Forefront) comments “...Currently, Medicare ACO models rely almost entirely on shared savings and penalties based on administratively determined benchmarks to encourage providers to use health care services more efficiently. We believe the Centers for Medicare and Medicaid Services (CMS) could harness competition among ACOs by giving beneficiaries meaningful incentives to choose more efficient ACOs, using its policy tools to capitalize on what ACO models have revealed.” Full