In the News: August 25-31, 2016

Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.

CMS Releases ACO Results for 2015

On August 25, CMS released the 2015 performance year data for Medicare’s Pioneer Accountable Care Organization (ACO) Model and Medicare Shared Savings Program (MSSP) Track 1 and 2 ACOs. Of the 12 Pioneer ACOs, 6 earned shared savings, 1 owed shared losses, and 5 other ACOs were below thresholds for sharing savings or losses. For the MSSP, of the 392 ACOs, 119 earned shared savings, and none of the Track 2 (downside risk) ACOs owed shared losses. Overall, experienced MSSP ACOs were more successful, with 42% of ACOs in the fourth year of participation earning shared savings, compared to 21% of first-year ACOs. For complete results for MSSP ACOs access the CMS data online.

As participation in population health–based payment models grows, Sg2 offers up some straight talk about the organizational competencies, market characteristics and payment environment needed to make population health work.

Read: Sg2 Report: Population Health Management

Continuity of Care for Older Adults Decreases ED Utilization

A recently published study in the Annals of Emergency Medicine investigated whether the visiting patterns of older patients seeking ambulatory care were related to their use of ED services. Researchers found that older adults with more ambulatory visits had lower ED utilization than those with fewer ambulatory visits.

Sg2 has been monitoring the ED landscape and the convergence of trends that influence ED volumes—aging population, health care reform, the transition to risk, and a focus on care coordination and the care continuum.  Understanding these trends in your market is key to making sound decisions on your ED strategy. Listen to Sg2’s discussion of ED strategy from our recent webinar:

Watch: Sg2 On-demand Webinar: Building an ED Strategy to Meet Tomorrow’s Consumer Needs

Multidisciplinary Approach Reduces Super-Utilizer Hospitalizations

A NEJM Catalyst study of the University of Florida Health Care One Clinic observed how Care One’s multidisciplinary approach to care for super-utilizer, high-cost patients drove a 25% reduction in super-utilizer hospitalizations and 11% reduction in ED visits in 6 months. Highly coordinated treatment for pain and behavioral health issues, in addition to taking the time to listen and earn patient trust, helped address the chronic pain and addiction challenges of these patients in a financially sustainable way.

Patients with multiple chronic conditions drive spending across the US, evidenced by the staggering 93% of total Medicare spending that goes toward these beneficiaries’ care. To learn more about developing your chronic care strategy to address the challenges facing these populations, see below:

Read: Sg2 Report: Developing a Market-Driven Chronic Care Strategy

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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