Posted in Accountable Care, ACO, MSSP

Busy Week in DC

By Gregg A. Masters, MPH

Last week it was xx in health, followed by the Health Datapalooza and winding down at Medcity News Engage: Unlocking Patient Engagement Through Innovation where I moderated the panel: ‘Patient Engagement in An ACO World‘:

This week it’s back to back sessions beginning Monday, June 10th at the National Bundled Payment Summit, followed by the National Healthcare Innovation Summit and concluding with the 4th National ACO Summit.

In this morning’s session I was struck by Andrew Osterman of The Advisory Board admonition suggesting the Bundled Payment Care Improvement (BPCI) may be a more suitable gateway drug into the ACO theater than the MSSP. Osterman suggested the MSSP financial incentives were probably not the most effective means to attract participation in the program at least from a hospital’s ‘lost revenue’ opportunity perspective that would likely not be offset by a 50% gain sharing arrangement with CMS.

But the line that really captured my attention as this speaks to the underlying schizophrenia between health policy and law via the Affordable Care Act and present day volume based financial incentives:

Success in risk based contracts requires hospitals to understand their volumes through the lens of episodes of care. Today, hospitals’ have no incentives to create systems which can analyze what care falls within an episode of care

There is more to come, so stay tuned!

For the complete set of CMS innovation including the four models of Bundled Payment program, click here.

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