Survey: 13% of Hospitals Plan to form ACOs

Only 13 percent of hospitals reported participating in an accountable care organization (ACO) or were planning to participate in an ACO within a year, while 75 percent of hospitals were not considering ACO participation, according to newly published results from a 2011 survey by researchers at The Commonwealth Fund and the Health Research and Educational Trust. The most common ACO governance models were joint ventures between physicians and hospitals, 51 percent, and physician-led governance, 20 percent, according to the survey of more than 1,600 hospitals. Another 18 percent of ACOs have a hospital-led governing body. Only 2 percent are led by payers. The survey found that hospitals participating in ACOs or preparing to participate were more likely to be larger not-for-profit and teaching organizations, located in large urban areas, and belong to a health system, compared with hospitals that were not planning to be part of an ACO. Results also suggest that many hospitals that are currently pursuing an ACO strategy do not yet have the capabilities needed for population health management. Only one of five hospitals participating in or preparing to join an ACO reported using predictive tools to identify patients at high risk of poor health outcomes or high resource use.

Proposed 2013 Medicare physician fee schedule for top 10 Anesthesia & Pain codes

The proposed 2013 Medicare physician fee schedule contains a 27% pay cut for the top 10 anesthesia codes. The following chart provides a snapshot of how the reimbursement for anesthesia and pain management practices will be effected in 2013 for 10 of the most commonly billed codes unless Congress takes action to halt the pay cut.

The codes were selected based on the most recent utilization data for anesthesia and pain management specialists. The fees shown are for services performed by a participating physician in a non-facility setting. They have not been adjusted for locality.

Code

Description

2012   Fee

2013   Fee

20610

Drain/inject joint/bursa

$69.78

$50.58

27096

S/I Joint Injection

$171.55

$124.34

62310

Inject spine cervical/thoracic

$246.77

$178.87

64483

Inj foramen epidural l/s

$242.01

$175.41

64493

Inj paravert f  jnt l/s 1 level

$181.08

$131.25

77003

Fluoroscopic guidance

$64.67

$46.88

99203

Office visit – new patient

$105.18

$76.23

99204

Office/outpatient visit new

$160.66

$116.45

99213

Office/outpatient visit est

$70.46

$51.07

99214

Office/outpatient visit est

$104.16

$75.49