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Get insights on CMS regulations, trends in Value Based Care, and other info to optimize the financial outcomes of your ACO.

Targeted HCC Risk Coding Investment Based on Calculated ROI of Gap Closure

Risk scores are an extremely important piece of the MSSP shared savings formula. Despite this, risk scoring rarely gets the attention it deserves. That’s because optimizing risk scores can be much more That’s because the how, when, and whys of investing into risk scoring can have complicated answers. In this article we cover all the basics on effectively investing to increase risk scores.

Targeted HCC Risk Coding Investment Based on Calculated ROI of Gap Closure2021-04-29T05:39:57+00:00

Impact of the COVID-19 Pandemic on ACO Financials Under MSSP

While CMS exemption of COVID-19 related inpatient expenditures may decrease spending for ACOs, deferred care and outpatient costs associated with COVID-19 may still drive up expenses, leading to financial losses. In response, Validate has added to their services to include COVID-19 episode exclusions for more accurate updated benchmark calculations, risk score monitoring for optimal adjustment to the historical benchmark, beneficiary assignment adjustment for telehealth inclusion, and COVID-19 adjusted analytics.

Impact of the COVID-19 Pandemic on ACO Financials Under MSSP2021-04-29T05:40:19+00:00

Expanding Your Organization’s Network

If you’re not focusing on your provider selection in a fast changing VBC market, your organization is falling behind. Whether you are a small ACO, new to taking on financial risk, or a large and profitable ACO eyeing new opportunities, your strategy should include evaluating your provider selection and expanding your organization’s network.

Expanding Your Organization’s Network2021-04-29T05:38:56+00:00

Impact of the 2018 National Assignable Trend Factor on ACO Financials

Most ACOs do not use a sufficiently accurate national assignable trend factor. Even after recognizing the impact of national trend on shared savings, it is important to recognize that it’s still one of many inputs impacting shared savings. ACOs can improve their financials and mitigate risk exposure by proactively managing these inputs through multi-year scenario simulations.

Impact of the 2018 National Assignable Trend Factor on ACO Financials2021-04-29T05:38:27+00:00

Evaluation of Potential ACO Performance Bias from Retrospective and Prospective Assignment

This is the first study to simulate the prospectively and retrospectively assigned beneficiary populations for actual ACOs. Key metrics were evaluated for each of the 322 ACOs during the 2015 performance year. Despite significant differences between prospective and retrospective assignment, neither methodology shows performance bias.

Evaluation of Potential ACO Performance Bias from Retrospective and Prospective Assignment2021-04-29T05:37:51+00:00
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