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Cutting waste: Advancing beyond the ACO

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Modern Healthcare reported that “Chapin White, a senior policy researcher at the RAND Corp., pointed to the historic slowdown in Medicare costs as one of the most important trends in healthcare spending. But he also pointed out that the spending reductions have been achieved largely through rate cuts to providers rather than widespread adoption of risk-based payment systems. ‘ACO’s are really tinkering on the edges of the big picture of Medicare spending,’ White said.”Patient Centered Medical Homes and bundled payments are two other approaches ┬áto avoid rewarding providers for quantity of care instead of quality.

”Kristen Miranda, vice president for strategic partnerships and innovation at Blue Shield California, said the changing payment landscape is resulting in some strange bedfellows….she cited the not-for-profit insurer’s partnership with competitor Anthem Blue Cross to launch the $80 million California Integrated Data Exchange as evidence of unique collaborations aimed at creating a more efficient healthcare system.”

Some argue that ”paying doctors more for services provided at hospitals than they get paid for the same care delivered in an office is driving up costs and driving consolidation. ‘The site-of-service differential has to go,’ said Simeon Schwartz, CEO of New York’s WESTMED Medical Group,” Modern Healthcare reported.


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