The Rundown | Week of 9.30.2019

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ACOs Saved CMS $739M in 2018

Accountable care organizations (ACOs) saved the Centers for Medicare & Medicaid Services (CMS) $739 million in 2018, approximately $73 per beneficiary. Two-thirds of the 548 Medicare ACOs collectively contributed to $1.7 billion in total savings. Analysts attribute the increased savings to a greater number of ACOs in downside risk arrangements in which ACOs share a greater cut of the savings but must also help cover losses. These downside ACOs were more likely to achieve savings; 59 of 95 received bonuses compared to only 146 of 453 upside ACOs. The new Pathways to Success program, which went into effect in July, will accelerate ACOs’ transition from upside to downside risk.
>> Read More: CMS saved $739 million last year from Medicare ACOs

Older Adults Adopting Telehealth

According to the National Poll on Healthy Aging, only 4 percent of patients between the ages of 50 and 80 have had a telehealth appointment. More than half were unaware whether their provider offered this service or not, and nearly half worried technical issues would jeopardize their visit. “Among older adults who had a telehealth visit, about half said the overall convenience of a telehealth visit was better than an in-person office visit (47 percent), 36 percent believed an in-person office visit was better, and 18 percent thought the overall convenience was the same.” However, respondents were interested in potentially trying telehealth for “unexpected illness while traveling,” “return visit,” and “one-time follow-up after a procedure or surgery.”
>> Read More: Virtual Visits: Telehealth and Older Adults

Is Red Meat Unhealthy?

Updated clinical guidelines published in the Annals of Internal Medicine drew controversy after suggesting that red meat in not as unhealthy as previously thought. Researchers conducted five systematic reviews to reassess “certainty in the evidence, the magnitude of potential benefits and harms, and explicit consideration of people’s values and preferences” surrounding red meat consumption. Upon further study, the conclusion was to “ continue current unprocessed red meat consumption,” meaning, the evidence is not strong enough to support consuming more or less red meat. Researchers noted that red or processed meats’ reputation status as a carcinogen is “primarily based on observational studies that are at high risk for confounding and thus are limited in establishing causal inferences.”
>> Read More: Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium

Regulations, Patient Data, and Revenue Top 3 Barriers to Value-Based Care

A recent survey from Definitive Healthcare found that the “changing regulations,” “trouble with collecting and reporting patient information,” and “unpredictability of revenue stream and complexity of financial risk” were considered the greatest barriers to value-based care. Surveyors “polled 1,090 healthcare leaders across the provider, biotech, financial services, staffing, life sciences, IT, and consulting verticals to determine predictions for the future of the value-based care landscape.” Other notable barriers were lack of resources and gaps in interoperability. The main factor accelerating value-based care is “appropriate provider compensation and incentives.” Researchers noted: “However, more clarity may be needed to entice providers to jump on board the value-based train.”
>> Read More: The Future of Value-Based Care: 2019 Survey Results

Trump Executive Order to Add Medicare Benefits

President Trump recently signed an executive order expanding Medicare Advantage (MA) plans. The order, “Protecting and Improving Medicare for Our Nation’s Seniors,” also attacked the proposed Medicare for All Ac of 2019, which would “upend Medicare as we know it.” Policywise, the order aims to “ improve the Medicare program by enhancing its fiscal sustainability through alternative payment methodologies that link payment to value, increase choice, and lower regulatory burdens imposed upon providers.” Furthermore, the order would expand “innovative MA benefit structures and plan designs” and reduce “barriers to obtaining Medicare Medical Savings Accounts and that promote innovations in supplemental benefits and telehealth services.”
>> Read More: Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors