null

Are ACOs Getting the Short End?

There is much to sort through in this... but the blog did again raise what I consider to be an important point. Any of the Value Based initiatives of CMS (and other payers) put forth are based on two seemingly innocuous bits of math/method --- Attribution  and Risk Adjustment. All the evaluation work of the academics often leads to a seemingly obtuse conversation of "was the change real or was it measurement?" The key to answering those questions lies in addressing both attribution and risk adjustment in new ways. What we have seen in our work at Nascate suggests that an industry that has built "complete coding" into MA has not figured out how to extend that work to ACOs -- because the uncertainty of attribution and the lack of months of guaranteed revenue (very different from MA) has made the ROI of existing methods insufficient. We believe we have the answer to this dilemma -- and it coincides with our predictive micro-targeting that also results in better care and a better experience.

Check out the article here: https://www.healthaffairs.org/do/10.1377/hblog20190813.223707/full/

-Bill Kelly

 

William P. Kelly is our Chief Executive Officer. He has extensive executive level experience in healthcare leadership, policy, and strategy and previously founded and served as President and Principal of Treo Solutions, LLC. As a widely recognized leader in payment policy and an expert in healthcare analytics, services, and M&A, William has published articles, edited books, and spoken nationally about the business of healthcare.