Providers and private payers may be ill-prepared for the risk sharing that comes with accountable care organizations (ACOs) under the Medicare Shared Savings Program, according to a report released yesterday by The Commonwealth Fund.
Even though they may be supported by payers, providers lack the infrastructure to manage the risk and need more data about patient populations, according to the Commonwealth Fund news brief. Researchers found that shared payer-provider risk payment models are still in the developmental stages, and few operational ones vary from the traditional capitated HMO model.
In addition, providers and payers have varying definitions of risk, although most models evolved from shared-savings programs.
"Alignment between Medicare and the private sector will be critical to strengthen the impact of each other's reforms, sending consistent signals to and intensifying incentives for health care providers to improve quality and reduce costs," states the news brief. "...It is unlikely that there will ultimately be a 'one size fits all' solution; it will be important to learn which models work best in which situations."
For more:
- read the full report (.pdf)
- check out the news brief
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