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In the News: September 6–13

Low-Acuity Patients Are Seeking Non-ED Treatment

A Journal of the American Medical Association study published this month analyzed changes in low-acuity utilization at urgent care centers, retail clinics and EDs using Aetna-provided commercial claims between 2008 and 2015, with the researchers finding that ED visits for low-acuity conditions decreased by 36% during this time.

The authors found that utilization of the non-ED sites of care for low-acuity conditions increased overall by 140%. Of those sites, retail clinics saw the largest increase (219%), followed by urgent care centers (119%). The study also found that spending per person per year increased 14% for low-acuity patient visits because of a 79% increase in price per ED visit for low-acuity conditions.

Sg2 previously projected the shift in low-acuity utilization from high-acuity sites to lower-acuity sites and expects this trend to continue, with flat growth in overall ED volumes projected over the next decade. To learn more about the shift in utilization across sites of care, read the Sg2 Expert Insight Sg2 2018 Impact of Change® Forecast: Rising Acuity Impacts Utilization.


More Than One-Fifth of US Adults Report Feelings of Loneliness

A recent international survey developed by The Economist and the Kaiser Family Foundation on loneliness and social isolation in the United States, United Kingdom and Japan found that 9% of adults in Japan, 22% in the United States and 23% in the United Kingdom always or often experience feelings of loneliness or isolation.

According to the survey, the level of social Isolation in these nations is due to a variety of reasons, such as more people opting to live alone and fewer people opting to join social communities like church groups or sport teams. An emerging factor contributing to loneliness has been technology, especially among the younger population.

Sg2 believes that emerging technologies such as digital assistants can actually be used to enhance home health care, as well as contribute to the reduction of loneliness. To learn more about how these types of technologies can be utilized to combat loneliness and isolation, watch the Sg2 on-demand webinar Disrupters to Watch in 2018 starting at minute 15:50.


Medicare ACOs Saved CMS $314 Million in 2017

According to a recent Modern Healthcare article, CMS made a profit from the Medicare Shared Savings Program (MSSP) in 2017, with approximately 60% of the 472 Medicare accountable care organizations (ACOs) generating a total of $1.1 billion in savings, and CMS sharing $780 million of that savings with the ACOs. CMS has previously lost money through the program, including losing $39 million in 2016 due to paying out more bonuses to ACOs than they generated in savings.

CMS recently proposed significant changes to MSSP, signaling its intent for ACOs to assume downside financial risk. In light of these dramatic proposed changes, Sg2 believes organizations need to assess their value-based care strategy moving forward. For strategies on entering the “glide path” to downside risk in the Medicare ACO program, read the Sg2 Expert Insight Adding Accountability to ACOs: Key Takeaways From the CMS Proposed Rule for the MSSP.

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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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