Impact Insights

Week in Review 6/12/15

Late last week, CMS published a final rule updating the Medicare Shared Savings Program (MSSP) – which is CMS’ biggest ACO initiative.  The final rule extends the time that ACOs can participate in the incentive-only phase of the MSSP (also known as “Track 1”).  Once an ACO has completed an initial 3-year agreement under “Track 1” they will now be allowed to sign up for a another 3 years before they are required to transition to “Track 2” – which offers higher incentives but requires the ACO to take on a certain amount of financial risk.  The final rule also establishes a completely new “Track 3” option that will increase potential incentives – and the level of risk – even further.  In total, there are more than 400 ACOs participating in the Medicare Shared Savings Program – however only 5 chose to start the program under “Track 2.”

Impact Advisors’ Thoughts:  The 592-page document isn’t exactly light reading, but the change allowing ACOs to participate in “Track 1” for a second 3-year term is important and will give newer Medicare ACOs more time to refine processes and IT strategies without being subject to penalties.  The addition of a third track is also notable, as it underscores CMS’ continued efforts to try and incentivize experienced ACOs to take on more financial risk for their performance.

A new study in Health Affairs looks at trends in health insurance coverage among US adults ages 18-64.  Between September 2013 and February 2015, the authors found there was a net increase of 16.9 million people with health insurance in the US, with 22.8 million people getting coverage and 5.9 million losing coverage during that time.  (See the study itself for more details.)

Impact Advisors’ Thoughts:  Changes in patient insurance coverage can have a significant impact on provider organizations, so these types of studies are good to keep an eye on.  Bear in mind that the numbers above only pertain to US adults between the ages of 18-64, so Medicare-eligible beneficiaries are not included.

Becker’s Hospital Review has published a great list of “50 things to know about healthcare data security & privacy.”  Among the stats we found most interesting was that healthcare has the highest “cost per stolen record” of any other industry, at $363.

Impact Advisors’ Thoughts:  There are a lot of fascinating numbers in Becker’s list – and the authors also provide a nice review of some important HIPAA rules.  Information security requirements in healthcare can get very confusing very quickly, so this story is definitely one we recommend bookmarking for reference!