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Peter Wehrwein's blog

Contributing Voices
Peter Wehrwein

The use of new hepatitis C therapies will increase rapidly, but the effect on spending is greatest early on, according to a PricewaterhouseCoopers analysis. According to the consulting firm’s projections, the expensive medications will eventually lower health care spending because they will improve the health of people with hepatitis C patients, so liver transplants and other high-cost medical interventions will be avoided.

Source: “Medical Cost Trend: Behind the Numbers 2015,” PricewaterhouseCoopers Health Research Institute, June 2014. PwC analysis based on National Health and Nutrition Examination Survey and 2012 Truven claims data from employers.

Contributing Voices
Peter Wehrwein

Three more organizations have exited CMS’s Pioneer accountable care organization (ACO) program, leaving just 19 of the original 32 participants in the fold for the elite program’s third year.

The Franciscan Alliance in Indianapolis, the Genesys Physician Hospital Organization in Flint, Mich., and the Renaissance Health Network in Wayne, Pa., in the southeastern part of the state, are leaving the Pioneer program, according to a list posted on the CMS website this afternoon.

Sharp Healthcare in San Diego had announced in August that it was dropping out.

Contributing Voices
Peter Wehrwein

Maybe, just maybe, accountable care organizations (ACOs) are the best bet for hitting the health care exacta of controlling costs and improving the quality of care.

Figures released by CMS on September 16 showed that the 23 organizations in the elite Pioneer program and 220 in the Shared Savings program produced over $372 million in savings while earning $445 million in shared savings payments.

Contributing Voices
Peter Wehrwein

So last week it was all doom and gloom about Pioneer ACOs.

The buzz in health care wonkdom was all about 9 of the 32 organizations defecting from a program supposedly designed for the best and brightest of American health care organizations — with maybe more to follow. Accepting downside risk was just too perilous. Lags in getting data from Centers for Medicare & Medicaid Services (CMS) were undermining cost and quality control efforts. And the contradiction of being responsible (aka accountable) for the costs of Medicare enrollees but having no direct control over where they receive care — a central feature of the ACO model — was simply untenable.

But this morning CMS attempted to change the doleful Pioneer ACO tune with a long-awaited announcement of cost and quality results from 2012, the first year the Pioneer ACOs were in operation.

Meetings

HealthIMPACT Southeast Tampa, FL January 23, 2015