Results from performance period 3 (PP3) were somewhat concerning because the amount of practices that achieved a shared savings stayed stable from PP2, explained Basit Chaudhry, MD, PhD, founder of Tuple Health.
Results from performance period 3 (PP3) were somewhat concerning because the amount of practices that achieved a shared savings stayed stable from PP2, explained Basit Chaudhry, MD, PhD, founder of Tuple Health.
Transcript
With results from OCM performance period 3 now out, did you see improvement over performance periods 2 and 1?
It’s interesting. In PP3, 33% of practices were able to achieve a shared savings. I think that was somewhat concerning because that’s stayed stable since PP2. So, in PP2, there was also 33% of practices that achieved a savings. In PP1, it had been 25%. So, between PP1 and PP2, we saw a growth or improvement. I personally was hoping that we’d continue to see aggregate improvement in performance in terms of achieving a shared savings. That unfortunately didn’t happen, so that aspect of performance leveled out.
The other thing that was important about the results that we saw from PP3 is that we’ve gotten additional data on what’s happened in the true-up period. So, true-ups are roughly, Medicare claims can be sent in about a year after a service is provided. So, in performance-based models, you continue to look at what happens as claims roll out or into Medicare. So, for PP1, the number of practices that retained a shared savings went from 25% to 20%. For PP2, it went from 33% to 25%. So, there’s kind of 2 trends I think that are concerning with the results of shared savings. One is we’ve leveled out in terms of the proportion of practices that have achieved a shared savings, and then the true-up process, we’re seeing a regression of the results.
Now, from what we understand from Medicare, different practices are getting shared savings at different times. So, overall from what they’ve said is that from the start of the program, around 50% of all the participants have achieved at least 1 shared savings. So, I feel like that’s progress in certain respects, but in aggregate, I think there’s still concerns over where practices are. The other thing I think is sort of how do you look at performance versus the benchmark. So, the benchmark doesn’t take into account the amount that’s provided from the MEOS [Monthly Enhanced Oncology Services] payments or the 4% discount, which is supposed to neutralize that. So, practices are doing better with respect to the benchmark; about three quarters of practices, from what we understand, are under benchmark. But, there’s still a concern there on how people are doing with respect to performance-based payments, and what this means is the upshot of it is that if practices are going to stay in OCM, a good proportion most likely would need to go to a down-sided risk model.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More
A Focus on Women: AUA Best Posters Highlight Female Athletes, Prenatal Care, and Women in Urology
May 9th 2024Three posters from the American Urological Association (AUA) 2024 Annual Meeting focused on urinary incontinence in female athletes, prenatal care for fetuses with spina bifida in California, and the experiences of women residents at the Brady Urological Institute.
Read More