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Commercial Insurers Less Likely to Offer ACOs 'Upside-Only' Shared-Savings Arrangements, Study Finds
Commercial insurers participating in accountable care arrangements are less likely than Medicare to use payment models featuring the “upside-only” shared savings preferred by providers, according to an analysis released Wednesday by the Premier healthcare alliance.
Premier's study of 85 ACO payer arrangements showed that more than one-third of these are for upside-only shared savings—where savings are split evenly between insurers and providers and there are no penalties imposed for failing to meet goals. But of these upside models, only 21% are offered by commercial payers; more than half are through the Medicare Shared Savings Program or Medicare Advantage.
Read the full story here: http://bit.ly/111j67k
Source: Modern Healthcare
A Premier official criticized commercial insurers for not doing more upside-only payment arrangements. Upside-only options are more attractive to providers, particularly in the early years of an ACO, because they allow providers to test care delivery models without the fear of financial losses while also offering the opportunity to earn enough in shared savings to offset ACO development costs.
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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