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New Calculator Helps Payers/Providers Estimate Success for ACOs

by Fred Pennic 01/07/2014 Leave a Comment

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New savings calculator ensures payers and providers better estimate the likelihood of success for ACOs for achieving desired quality and savings goals. 

A new online calculator has been developed to help payers and providers better estimate the likelihood of success for ACOs by the Health Care Incentives Improvement Institute (HCI3), a not for profit that develops and tests payment innovation models, and IMPAQ International, a research, evaluation, survey and technical assistance firm.

According to recent research by CMS, ACOs can be misclassifying ACOs as ‘winners’ or ‘losers’ given the underlying variability of total costs of care in a patient population.

The Accountable Care Organization Savings Calculator (ASC) is an online tool designed to help providers and payers understand how chance affects the likelihood that an ACO will be rewarded for savings under an ACO contract.

Jointly developed by HCI3 and IMPAQ, the ASC draws on statistical models published in Medicare & Medicaid Research Review to allow payers and providers to assess the probability that an ACO will be rewarded if it achieves a specific trend rate target (depending on the size of the patient group under management and other terms of the financial contract between the payer and the ACO). The estimates take into consideration the underlying variability of the payer population’s historical total costs of care per member.

“Since ACOs have the ability to transform the U.S. health care landscape and with the stakes high for everyone, it’s important to have confidence in the outcomes. That’s why we worked with IMPAQ to developed this tool and remove some of the uncertainty that exists for payers and providers,” said Francois de Brantes, executive director for HCI3.

“As ACOs continue to evolve and grow, so will the types of contractual relationships between payers and providers,” said Dr. Ines Vigil, managing director of IMPAQ’s Consulting Services team, which developed the calculator as part of the IMPAQ Analytics suite of tools aimed at helping businesses successfully navigate the regulatory and policy landscape. “We are dedicated to helping provide analytic tools like the savings calculator to those interested in understanding the role that chance plays in realizing a shared savings payment – managing and reducing risk in a way that maximizes the reward.”

For more information, click here to start using ACO Savings Calculator

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