Improving Performance

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Can value-based purchasing in health care live up to the promise?

By Jerome Connolly, PT, CAE
May 5, 2014

On March 4, 2014, the RAND Corporation released a new report concluding that after a decade of experimentation with reforms that give health providers financial incentives to improve performance—so-called value-based purchasing—relatively little is known about how to best execute such strategies or to judge their success.

The report—authored by Cheryl L. Damberg, Melony E. Sorbero, Susan L. Lovejoy, Grant Martsolf, Laura Raaen, and Daniel Mandel—which was designed to assess the state of knowledge about value-based purchasing programs in health care, found that evidence thus far is mixed about whether using such payment schemes can help improve quality and lower costs.1

Growth of ACOs

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Continued growth of accountable care organizations could impact private practice physical therapists.

By Jerome Connolly, PT, CAE
April 4, 2014

A December 2013 announcement1 by the Centers for Medicare and Medicaid Services (CMS) provides evidence of the growth of the so-called Accountable Care Organizations (ACOs). The 123 new ACOs bring the number of Medicare ACOs to 366. In addition, the best estimate for the total number of public and private ACOs is 606.

A list of the 123 new Medicare ACOs announced in January can be found at: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/2014-ACO-Contacts-Directory.pdf.

Prospects Brighten for Sustainable Growth Rate and Therapy Cap Repeal

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By Jerome Connolly, PT, CAE
March 3, 2014

Congress must have been affected by the holiday spirit in December when two key committees passed separate bills that would lead to repeal of the long dysfunctional sustainable growth rate (SGR) formula used to calculate therapist and physician payments under the Medicare Physician Fee Schedule.

Congress has been providing waivers and short-term patches to the policy almost annually since 2003. And three committees of jurisdiction expressed sincere interest in early 2013 in enacting legislation that would finally repeal the arcane formula. The congressional committees got off to an early start last year in circulating concept papers, holding hearings, and seeking extensive input from stakeholders. PPS participated vigorously in that process.

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