First Look At ACO

Question 1

Why ACO that target certain procedures may not achieve savings (3)

Answer 1

1. ) little variation between well and loosely managed ambulatory care sensitive admissions by condition
2. ) greater differences in IP util efficiency and total Medicare cost
3. ) suggest that system change is required to produce necessary results

Question 2

Considerations regarding MSSP (7)

Answer 2

1. ) improving quality may not generate necessary savings
2. ) ACO that target certain procedures may not achieve sufficient savings
3. ) few orgs willing to make necessary changes
4. ) risk analysis by potential ACOs of until of services is required to meet target levels
5. )Provider orgs may not have proper talent to successfully manage as an ACO
6. ) ACO operating efficiency with low IP util and cost need to focus on non IP services and non Medicare populations to achieve significant savings
7. ) ACO spending targets based on prior experience