policy

ACOs and Payment Reform

The Business Group strongly supports reforms that transition away from fee-for-service (FFS) payment arrangements to those which place a focus on value-based payments, including accountable care arrangements, medical homes, and similar delivery changes that encourage care coordination and provider accountability for population health.

An Accountable Care Organization (ACO) is a group of health care providers in a care delivery system who agree to accept joint responsibility for the medical care and management as well as the cost and quality outcomes of a designated population of patients. Because of this shared responsibility, ACOs hold the potential to transform the organization, delivery, and financing of care and reduce fragmented, uncoordinated care with an arrangement in which providers work together to achieve shared goals of better care at a lower total cost.

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Featured Resources

National Business Group on Health's Position Statement on Accountable Care Organizations (ACOs) National Business Group on Health's Position Statement on Accountable Care Organizations (ACOs)
The National Business Group on Health believes that effective Accountable Care Organizations (ACOs) must improve the quality and efficiency of care while not unduly raising prices for any patients or payers in their communities.

 

 The Primary Care Imperative: New Evidence Shows Importance of Investment in Patient-Centered Medical Homes (PCMH) The Primary Care Imperative: New Evidence Shows Importance of Investment in Patient-Centered Medical Homes (PCMH)
Gives an overview of the PCMH model, reviews the exciting evidence, addresses common employer concerns, and provides employer recommendations.

 

Proposed Rule for the Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2018 Rates (CMS‐1677‐P) Comments to CMS on Proposed Rule for Medicare Hospital Inpatient Payment for 2018
The National Business Group on Health submitted comments to support expansion of performance-based payment in Medicare and refinements to quality measurement and other improvements in Medicare.

 

 

Also of Interest

ACO Toolkit: A Roadmap for Employers
Provides a road map on implementing an ACO strategy from assessing market opportunity, understanding ACO readiness, considering plan design options, improving employee engagement and evaluating ACO performance.

Questions for Employers to Ask Health Plans When Considering a PCMH Strategy
This Checklist is designed to help employers consider opportunities for investing in patient-centered medical homes (PCMH) in partnership with their health plans. New evidence shows PCMHs consistently achieving reductions in unnecessary utilization and costs.

Employer Perspectives On Accountable Care: ACO Definitions, Key Considerations, and Recommendations
This issue brief lays out definitions of accountable care organizations (ACOs), key questions employers should consider when looking at investing in an ACO strategy, and an overview of employer perspectives and concerns related to ACOs. This publication was created in collaboration with Leavitt Partners and the Robert Wood Johnson Foundation.

Letter to House Speaker Ryan Opposing Legislation that Would Weaken Medicare Site-Neutral Payments
In response to recently-passed legislation (H.R. 5273), the Business Group sent a letter to House Speaker Paul Ryan expressing concerns about exempting mid-build off-campus hospital outpatient departments (HOPD) from the site-neutral payment requirement in Section 603 of the Bipartisan Budget Act of 2015.

 

Also of Interest

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