Risk bearing and use of fee-for-service billing among accountable care organizations

American Journal of Managed Care

Volumn 19, Issue 7, 2013, Pages 589-592

  Muhlestein, David B ^a,b   Croshaw, Andrew A ^b   Merrill, Thomas P ^b  

^a OHIO STATE UNIVERSITY   (United States)

^b Leavitt Partners   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACCOUNTABLE CARE ORGANIZATION; ARTICLE; FEE; HEALTH CARE; HUMAN; PATIENT CARE; PRIORITY JOURNAL; REIMBURSEMENT; UNITED STATES; ECONOMICS; MEDICAL FEE; ORGANIZATION; QUALITATIVE RESEARCH; RISK MANAGEMENT;

ACCOUNTABLE CARE ORGANIZATIONS; DECISION MAKING, ORGANIZATIONAL; FEE-FOR-SERVICE PLANS; HUMANS; QUALITATIVE RESEARCH; RISK SHARING, FINANCIAL; UNITED STATES;

EID: 84883760284     PISSN: 10880224     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (8)

1. Berwick DM. Making good on ACOs' promise - the final rule for the Medicare Shared Savings Program. N Engl J Med. 2011;365(19):1753-1756.
2. Muhlestein D, Croshaw A, Merrill T, Peña C. Growth and Dispersion of Accountable Care Organizations: June 2012 Update. Leavitt Partners; 2012. http://leavittpartners.com/wp-content/uploads/2012/06/Growthand-Dispersion-of- ACOs-June-2012-Update1.pdf. Accessed December 10, 2012.
3. Berwick DM, Nolan TW, Whittington J. The Triple Aim: care, health, and cost. Health Aff. 2008;27(3):759-769. (Pubitemid 351770245)
4. Interviewed ACOs are located in the following Census Regions: 19 in the Midwest, 14 in the Northeast, 9 in the South, and 15 in the West. http://www.census.gov/geo/www/us-regdiv.pdf for a list of states included in each region. All hospital-based ACOs are led by general hospitals, 2 of which are general children's hospitals.
5. These first interviews represent a convenience sample as they were the organizations that we were first able to interview. Approximately 40 percent of the total ACOs we have identified are led by physician groups compared with the 21 percent in our sample.
6. Fisher ES, Staiger DO, Bynum JPW, Gottlieb DJ. Creating accountable care organizations: the extended hospital medical staff. Health Aff. 2007;26(1):w44-w57.
7. Hussey PS, Ridgely MS, Rosenthal MB. The PROMETHEUS Bundled Payment Experiment: slow start shows problems in implementing new payment models. Health Aff. 2011;30(11):2116-2124.
8. Medicare Payment Advisory Commission. Report to the Congress: Reforming the Delivery System; 2008.