Accountable Care Organization

ACOs, Texas-Style - 07/17/2023

Burdensome federal regulations and antitrust rules and hefty overhead costs are oft-cited stumbling blocks to physician involvement in accountable care organizations (ACOs). So perhaps it came as little surprise when the Texas Legislature, less than enamored with the federal health reform legislation that authorized the coordinated care models, came up with its own rendition. In 2011, state lawmakers passed Senate Bill 7, which created a Texas-style ACO, known as a health care collaborative, to encourage physicians, hospitals, and payers to collaborate on more coordinated, cost-effective health care delivery. Now that the Texas Department of Insurance has adopted rules laying out a path to licensure as a collaborative, Texas physicians have a more flexible option that overcomes many of the barriers preventing them from stepping into integrated care models.

Mastering Quality Reporting: Ease the Challenge of Quality Reporting - 07/10/2023

Understanding the maze of quality reporting pathways may help ease the challenge.

Medicare Bundled-Payment Model Could Expand Access to Value-Based Specialty Care - 01/26/2023

Medicare’s recent extension of a bundled payment model marks a rare opportunity for more specialists to participate in value-based care and could pave the way for better coordination with primary care.

New TMA Task Force on Alternative Payment Models Charts a Path Toward Value-Based Care - 01/26/2023

The shift from fee-for-service to value-based care is underway, with public and private payers introducing myriad new payment models in recent years. But many physicians find the variety of plans overwhelming, and the investments necessary to support them challenging.

Medicare Fee Schedule a Mixed Bag for 2023 - 01/26/2023

The Centers for Medicare & Medicaid Services (CMS) recently posted the 2023 Medicare Physician Fee Schedule, which takes effect Jan. 1 and brings with it a mixed bag of consequences for physicians.

Holding Their Own: Texas ACOs Contribute to Billions in Savings in Medicare Program - 11/01/2022

For the fifth straight year, the Medicare Shared Savings Program (MSSP), through its work with accountable care organizations (ACOs), generated significant savings and high-quality results, with Texas entities once again contributing to that success.

What's New in Value-Based Care - 09/23/2022

Once dubbed unicorns, value-based care (VBC) models that eschew fee-for-service payment in favor of rewarding quality have materialized; the Texas Medical Association aims to be on the crest of this wave with the formation of its new Task Force on Alternative Payment Models.

Texas ACOs Contribute to $1.6 Billion in Savings in Medicare Shared Savings Program - 09/09/2022

For the fifth straight year, the Medicare Shared Savings Program (MSSP), through its work with accountable care organizations, generated significant savings and high-quality results, with Texas entities once again contributing to that success.

Medicare ACOs Face Key Changes in Proposed Fee Schedule - 08/10/2022

In an effort to boost participation in accountable care organizations, Medicare has significant changes to its shared savings program on tap in the proposed 2023 physician fee schedule.

Value-Based Care for All: Practices of All Sizes Can Make the Switch - 07/29/2022

Moving away from fee-for-service requires taking on risk as well as hiring staff, launching new programs, and investing in data analysis, but practices of all stripes have made the switch successfully.

Rewarding Results: Texas Medicare ACOs Perform Promisingly - 11/30/2020

For the Medicare Shared Savings Program (MSSP) and many of the accountable care organizations (ACOs) that participated in it, 2019 was billed as a transition year. But data released by the Centers for Medicare & Medicaid Services (CMS) in September show Texas ACOs fared quite well last year – and a number of Texas physicians and ACO officials say the savings generated are worth the gruntwork that MSSP requires.

This Month in Texas Medicine - 12/03/2018

The December edition of Texas Medicine looks at accountable care organizations in Texas. Plus, see what's new in the TMA Education Center.