SigmaWay Blog

A recent study suggests that more than two-third of US population is being served by the ACOs. According to Department of Health and Human Services' the latest approval of ACOs in January brings the total number of Medicare ACOs to 368, up from 259 last year. Currently there are total 522 ACOs serving both Medicare and non-Medicare patients. According to CMS, 10% of Medicare beneficiaries will receive their healthcare from ACOs. The research also found that Medicare ACOs are serving near about 33 million non-Medicare patients. Though there is a significant growth in ACO participation, Mr. Niyum Gandhi, a partner in Oliver Wyman's Health & Life Sciences practice and one of the firm's experts on ACOs, criticized the fact by saying "The process of shifting American healthcare to a new, sustainable model is nowhere near the finish line. On the other hand, these numbers mean we have a critical mass lined up at the starting gate." To know more, follow the article written by Oliver Wyman (leader in management consulting) at: http://www.marketwatch.com/story/accountable-care-organizations-now-serve-up-to-17-of-americans-2014-04-23?reflink=MW_news_stmp

CMS has announced that surveyors will scrutinize dementia care and Minimum Data Set coding in an upcoming pilot program. The programs are expected to start from mid 2014. The survey will be concentrated on the processes of antipsychotic prescribing. The special Minimum Data Set surveys will evaluate coding practices and examine how well facilities link care plans to MDS assessments. For more details please visit:http://www.mcknights.com/special-surveys-on-dementia-care-minimum-data-set-coding-will-launch-by-mid-year-cms-announces/article/343573/

The American Hospital Association (AHA) is lobbying CMS to modify the shared savings rule. According to AHA, the current rules are bringing too much financial risk to the providers without offering them enough financial rewards. A recent report suggests that out of 114 providers in Medicare Shared Savings Program, only 29 were able to realize the savings. AHA has recommended that CMS should extend ACO engagement period from 3 year to 6 year. As per Linda E. Fishman, an AHA senior vice president of public policy analysis and development, the only way CMS can encourage ACO participation is by modifying shared savings program. For more details please visit Ron Shinkman's article link: http://www.fiercehealthfinance.com/story/hospitals-want-cms-ease-aco-rules/2014-04-21