ACO News


On February 15, 2016 the Florida Accountable Care services reached a milestone that sets precedent for the wave of the future in healthcare. Much like a presidential inauguration FACS kicked off its partnership with UnitedHealthcare. Alongside Primary care providers, Ancillary health providers, honored guest, U.S Sen. Bill Nelson (D-FL) and David Lewis—CEO of UnitedHealthcare.

The next big thing in health care is here and eyes are on Florida Accountable Care Services as it places itself at the forefront of the changing health care system. UnitedHealthcare recognized FACS for “partnering around the needs of society.” The partnership involves more than 20,000 people in central Florida. Starting April 1st 2016 the partnership will solidify and the real work begins for FACS to apply their expertise in health care innovation and patient-centered programs to improve the health of UnitedHealthCare participants and advance toward overall population health management.

UnitedHealthcare has been evaluating how to increase quality, reduce medical costs, and improve patient outcomes, as well as share risk and responsibility for controlling medical cost trends since 2010. UHC noted Accountable Care organizations (ACOs) to be an important element of its value based contracting strategy. With a goal set to increase collaboration between the health care community and emphasis on shared risk accountability for improved outcomes UnitedHealthcare saw value in a partnership with FACS.

FACS long-standing history proves that it has been successful in generating true savings through an independent Physician led and Physician governed membership and a robust clinical integration network. FACS achieved success when it saved the federal government $ 15 million dollars by streamlining care. Something UnitedHealthcare sees tremendous value in.

The day was marked by a sea of smiles, handshakes and joyous energy. The event was kicked off with a ribbon cutting ceremony to celebrate the grand opening of the Florida Emergent Care, located in the FACS hub building at the Medical Village in Winter Park, FL. A 24/7 care center hybrid between an emergency room and an urgent care facility that is able to provide services 10 times cheaper than going to an emergency room.

“These are big steps forwards,” said David Lewis CEO of UnitedHealthcare of Florida. This set the tone for the importance of the event. U.S Sen. Bill Nelson agreed stating in his speech: “The significance of today is that one of the largest health insurers in the state—with 3.5 million customers—United is teaming up with an ACO in order to bring those costs down and therefore to bring cost down in premiums.”

In response Dr. Sandeep Bajaj—Founder and CEO,FACS—stated: “We are very proud to work with them because I think that they’ll be toe to toe with us, as we want to challenge and push the envelope to make something really innovative and great for our patients. “

The event is a remarkable achievement for Florida Accountable Care Services since its inception in 2012. This is only one of many more achievements that are to come and to prove that FACS is working towards improving access to health information so that physicians are better able to coordinate a patient’s care across the care continuum. A major and notable part of the continuum is that FACS’ electronic health records are linked to the states system which provides results in real time.

As the health care system continues to change FACS is determined to continue its innovative approach. It will move forward making ripples that turn into waves of change for the better of the community that it serves. Partnering with health care giant UnitedHealthCare is only the beginning. FACS has also partnered with Cigna and Aetna. In a statement Dr. Sandeep Bajaj said: “Together, we expect to achieve even better health outcomes and improve patient satisfaction, while reducing the overall cost of care.”


By Greg Sanchez, Florida Accountable Care Service
Published: February 29, 2016


As 2014 draws to a close, we are finally beginning to see the results of some of the first, most basic types of studies that attempt to describe, characterize, or assess the progress of ACOs. Shortell, McClellan, Ramsay, Casalino, Ryan, and Copeland published such an article in the October 2014 issue of Health Services Research entitled “Physician Practice Participation in Accountable Care Organizations: The Emergence of the Unicorn.” They found that, to date, no studies had been published looking at the rate of individual physician practices joining or planning to join ACOs. Using data from the National Survey of Physician Organizations III (collected in 2012-2013), they were able to look at 1,183 practices that were in one of three groups: already in an ACO, planning to join an ACO within a year, or those that had no cur-rent plans to join an ACO. About a quarter of the practices were already participating in an ACO, with another 16% planning to join an ACO within a year. Nearly 75% of practices participating in ACOs had 100 or more physicians, even though nearly half of practices in the US are comprised of 5 or fewer physicians. Practices in New England and the East South Central region of the United States were also more likely to join ACOs, as well as practices that receive patients from an IPA or PHO. The study found no statistically significant differences in ACO participation based on ownership structure or specialty mix. The authors stress that it is typical for large, well-networked practices to be the earlier adopters of the ACO model, but there is a growing need for longitudinal studies that are able to assess how early adopters are achieving the ACO “triple aim” of better quality, better health, and lower costs.


Published: January 26, 2015


This article from December 2013 describes a cross-sectional study of all the accountable care organizations (ACOs) in the United States, as of August 2012. The researchers analyzed demographic and health care system characteristics for each ACO and were able to determine which factors were most associated with ACO presence. Many factors, such as competition and number of physician groups available, were found to have varying degrees of influence on ACO formation. For example, if fewer physician groups exist in an area, this may indicate that the groups are larger, leaving more opportunity for the presence of ACOs in a market. The 227 ACOs identified in the study were found to service nearly 1/3 of local areas, with over half of all Americans living in an area with at least one ACO. Furthermore, ACOs differed in their coverage, with most ACOs (37%) centralized in one area, while a full quarter of ACOs served eight or more areas. One indicator that significantly predicted presence of an ACO was an area with higher per capita Medicare costs, as well as those with less acute care beds. Regionally, the northeast featured the most ACOs, along with urban areas and areas of low poverty. This study is one of many that attempt to explain where (and why) ACOs are formed. To this point, this information has been fragmented and difficult to compile for adequate analysis. As more literature emerges that discusses the many different aspects of ACO formation and presence, more detailed analysis can define what factors make ACOs successful in terms of performance and health outcomes.

Lewis, V., et al. (2013). Accountable Care Organizations in the United States: Market and Demographic Factors Associated with Formation. Health Services Research, 48(6), 1840-1858.


By Yara Asi, Florida Accountable Care Service
Published: April 25, 2014


Florida Accountable Care Services is very proud and extremely pleased to announce our selection on May 5th, 2013, by The Agency for Healthcare Administration (AHCA) and the Harris Corporation to become a Node on the State of Florida Health Information Exchange (FHIE). After completing a thorough review of all respondents, Florida Accountable Care Services was selected amongst many applicants because of our shared belief in the FACS Team and its sheer wherewithal and leadership potential to contribute to the success of the Statewide Health Network for Florida.

The Florida HIE provides health care professionals with a timely, secure, and authorized way to exchange patient health information through two services. The Patient Look-Up and Delivery (PLU) service is a “network of networks” that brings existing provider networks together to provide a statewide information highway for Florida’s health care professionals. Information is queried for treatment purposes with patient consent. The Direct Secure Messaging (DSM) service is a secure email service that allows users to send and receive email messages and attachments containing a patient’s clinical data. DSM can be used for purposes of treatment, payment, and operations.

More specifically, DSM offers a more secure and efficient method for two-way communication and transmission of protected health information (PHI) than fax, phone, regular mail, or courier. The ability to electronically transmit patient records facilitates coordinated patient care; enhances communication between providers and facilities; and can reduce duplicate procedures, tests, and medications. DSM also supports meaningful use by enabling the electronic exchange of clinical information like Continuity of Care Documents (CCDs) and referrals. The DSM Participant Directory contains a listing for every registered user that includes DSM address, physical address, and phone/fax numbers. The Participant Directory allows other users to search for individual providers or organizations by name and/or location. DSM sends automatic read receipts whenever a message you have sent is opened and provides notifications to your regular email upon receipt of a message in your DSM inbox.

The sharing of patient data through the PLU service will lead to better quality health care for Florida’s citizens and specifically our Patients. PLU facilitates patient care, diagnosis, and course of treatment; enhances communications between hospitals, labs, pharmacies, and referring physicians; and reduces orders for duplicate tests, procedures, and medications. Enabling health care providers to access clinical records from multiple sources at the point of care will reduce costs and improve health care outcomes for patients by giving providers the most up-to-date and complete medical record possible. Our partners, ACHA and the Harris Corporation are no strangers to such large scale projects as this one. ACHA as most of you know is Florida’s chief health policy and planning entity for the state. In March 2010, the Agency was notified that it was awarded $20.7 million in federal funding to be used over a four-year period for the purpose of supporting statewide HIE. Harris Corporation is an international communications and information technology company. Harris Healthcare Solutions has been awarded a four-year contract by Florida’s the Agency for Health Care Administration (Agency) to establish and run the Florida HIE.

Over the coming months ACHA, FACS, and Harris Corporation will be working closely together on the full scale implementation and roll out to all our Physicians, as well as integrate our connections with Physicians and Hospitals in Alabama and Georgia and additional states coming on board in the near future. This is a testament to the staff of FACS (Vikram Saini), Guardian Health Solutions (Pranam Ben), and our IT/Sales consultant (Don Smith) that this major opportunity was obtained. As the only ACO Organization awarded this honor, It also points to the good work that our staff and associates are capable of as well as the opportunities that are available in this newly emerging health care market.

For more information please explore:


By Vikram Saini, JD, Florida Accountable Care Service
Published: June 17, 2013


On May 18th, at the beautiful Grand Bohemian hotel on a Saturday Afternoon, FACS along with over 30 primary care physicians, ancillary health providers, and several honored guests held its second annual ACO Summit for Florida Physicians Trust and the newly formed Central Florida Physicians Trust. We began the day with a discussion regarding ACO updates / paradigm shifts in the local market by Dr. Sandeep Bajaj, which transitioned quite nicely into a discussion regarding commercial ACO platforms by our honored guest Ms. Ruth Fricke, Senior Vice-President for Aetna Healthcare. Members of the FACS team Dr. Richard Cairl and Vikram Saini discussed the ACO quality metrics and some of the shared savings calculations, while we also received updates regarding the Guardian Health Solution. Our day was bookended by our keynote address from Florida Physicians Trust Medical Director, Dr. William Silverman of Lake Howell Family Medicine and myself, Dr. Dwight Jones.

Click here to view event pictures


Dr. Dwight Jones, Chief Executive Officer
Published: May 20, 2013


WASHINGTON — Physician-led accountable care organizations (ACOs) could have more opportunities to create savings in patient care with a little help from health insurers, a leading health reform expert said Wednesday.

Doctor-centric ACOs can do a better job at controlling costs than hospital-led organizations, Paul Ginsburg, PhD, president of the Center for Studying Health System Change here, said at an ACO summit hosted by America’s Health Insurance Plans.

Entrepreneurial insurance companies can offer loans to provider groups to expand or re-engineer to become ACOs through Medicare or commercial payers, Ginsburg said. Others can create innovative programs that have physicians take additional risk to improve outcomes and lower costs for patients.

“I think physician-led ACOs inherently make markets more competitive because they have an opportunity to shift patients toward higher-value hospitals,” Ginsburg said. “It means that a hospital market that might not have large competition going, all of a sudden, if there’s a physician-led ACO, those hospitals have to compete on price for the allegiance of those physician-led ACOs.” Unlike in hospital-led ACOs, doctor-led ACOs aren’t compromised financially by reducing hospital admissions and emergency department visits, he pointed out.

In fact, physician-led ACOs already outnumber their hospital counterparts, the latest data from the Centers for Medicare and Medicaid Services (CMS) show. However, doctor-organized groups typically treat fewer patients than those formed by hospitals.

Charlie Baker, former Secretary of Health and Human Services Secretary in Massachusetts, noted that nearly every shared-risk model in Medicare Advantage is with physician groups and not hospitals, he says, because insurers know that’s how to save money.

Baker said he believes there will be more growth in small providers pooling resources to become ACOs. “My big fear is they’re starting behind the larger players, way behind,” Baker said. Physician groups are still skeptical of quality metrics used to determine the shared savings in ACOs, Ginsburg said.

However, CMS rules on ACOs favor hospital-led organizations. “The CMS rules are making it exceedingly difficult for an independent physician group to form an ACO,” Baker said. To that point, Ginsburg noted the federal government can play a larger role in facilitating physician-led ACOs.

“I think of the federal support for the HMOs in the 1970s as to whether it’d be feasible to have the federal government support the development of physician organizations as an investment for viable markets in the future,” Ginsburg said.

No matter what happens, whatever strategy emerges to control costs must tackle provider payments — an area public and private payers seem to be in agreement on.

Jeff Goldsmith, PhD, professor of public health sciences at the University of Virginia in Charlottesville, called for more physician independent practice associations and doctor-sponsored health plans. He doesn’t believe hospitals should be the center for managing clinical risk in the health system.

“I think hospitals have an valuable important role to play, but to assume they’re going to voluntarily shrink their own franchise defies belief,” Goldsmith said.


By Vikram Saini, JD, Florida Accountable Care Service
Published: May 15, 2013


A large national payer recently announced the opportunity for Accountable Care Organizations (ACOs) to share in 100 percent of the savings they create for the payer’s largest book of business. Providers will have complete autonomy in how they manage the health of their population, and the payer will ensure the timely flow of datasets needed to support care improvement activities. The payer will pre-define the ACO’s population and its spending benchmark, which will be adjusted for the risk of the ACO population. Consumers aligned to the ACO will be offered supplemental benefits and financial incentives to seek care from the ACO’s network.

Market-watching ACOs can be forgiven for wondering how they missed the slew of journal articles, blogs, and op-eds lauding the “best practice” design features of this new model — because they never materialized. The deal in question is, of course, the Next Generation ACO model currently being offered by the CMS Innovation Center (CMMI). But perhaps because of the hit-and-miss track record of the Centers for Medicare and Medicaid Services’ (CMS) ACO portfolio over the past five years, the reaction of the health policy intelligentsia has been curiously tepid. Savvy provider organizations, however, are increasingly gravitating toward Next Gen’s market-leading deal terms. Those ACO operators that don’t consider the Next Gen model this spring risk being locked out for the foreseeable future.

Early Models

Early ACO models from CMS suffered from a number of flaws that hindered their effectiveness; this is particularly true for “Track 1” of the Medicare Shared Savings Program (MSSP), which ACCOUNTED for 330 of the 353 total Medicare ACOs in 2014. Three main flaws were most commonly cited by frustrated health system executives:

  • ACOs only share in a maximum of 50 percent of savings they generate — an amount that simply isn’t sufficient to fund the population health infrastructure and physician incentives necessary to fundamentally change practice behavior;
  • Physicians don’t know which patients they are financially responsible for until after the year is over, which prevents them from targeting care management interventions and ultimately improving patient care; and,
  • Patients have little incentive to receive care within the ACO’s network, which reduces the ability of physicians to coordinate care.

And yet, even with these flaws, a majority of early ACOs did save money relative to their target — indicating that the basic model, if modified, could work well for both health systems and CMS.

Incorporating Feedback

Fortunately, CMS heard the complaints about early MSSP models and addressed the majority of them through the progressive structure of the Next Gen model. In fact, the core difference between MSSP Track 1 and the current Next Gen model is that the latter is based upon extensive feedback from health systems regarding their concerns about MSSP Track 1.

Next Gen is therefore a program that health systems have directly asked for. The model still has room for further improvement — for example, Next Gen ACOs should have access to the full toolkit of benefit- and network-design strategies found in Medicare Advantage and other provider-led offerings. But the CMMI leadership has pledged to pursue additional features that could take effect in the later years of the Next Gen model, and will continue the virtuous cycle of improvements. The most significant improvements that the Next Gen model embodies are highlighted below.



Would-be Next Gen ACO participants must grapple with two primary hurdles: risk exposure and a closing decision window. Next Gen ACOs are at full risk for spending in excess of their target, subject to a 15 percent stop-loss cap. This financial exposure is certainly not trivial, but ACOs can mitigate it through two interrelated financial and operational strategies.

First, Next Gen ACOs should focus on a core set of population health capabilities — namely an analytics-driven approach to care management for the small segment of complex patients who are predicted to have high but impactable costs, and a disciplined approach to optimizing the risk adjustment and quality bonus portions of the ACO’s financial benchmark. And second, ACOs should protect themselves by sharing operational risk with an experienced partner and/or through the purchase of market-based financial protections such as reinsurance.

CMS is only offering new admission to Next Gen this spring for a January 1, 2017 start date. ACOs that want a shot at participating need to submit a non-binding Letter of Intent by May 2, 2016, with the full application due by May 25. After that window closes, a similar model is unlikely to be available again any earlier than 2020, when CMS could decide to expand it nationally.

The Next Generation ACO Model may come to be seen as the cornerstone of CMS’s efforts to shift the majority of its payments towards value-based care. For health systems it represents an opportunity to secure provider-friendly deal terms and help define their own destiny in a rapidly-evolving Medicare payment landscape.


Although connectivity among medical devices is not new, the Internet of Things (IoT), or the Internet of Medical Things if you will, is gaining traction as the healthcare industry has been increasing efforts to improve quality and the continuum of care.

What is IoT?

A report from The Advisory Board Company’s Health Care IT Advisor defines the Internet of Things (IoT) as “the connectivity and interoperability of increasingly smart objects, such as appliances, sensors, controllers, wearables, and medical devices.” estimated in 2015 the healthcare IoT market segment would hit $117 billion by 2020. Consulting firms, researchers, technology companies, among others, believe IoT platforms, composed of Internet-connected devices, will substantially develop over the next few years.


North America dominated the global healthcare IoT market in 2014 with about $24.6 billion in revenue and is expected to continue its dominance at least until 2020, a P&S Market Research report shows.

Individuals can play a more active role in their care with IoT wearables that capture and track their health data. Also, IoT has the potential of having a profound impact in healthcare areas such as remote patient monitoring, medication adherence, and intelligent hospital rooms. For example, Philips Lifeline offers a medication dispensing device that functions as an IoT product. It automates patients’ pill-taking process by sending reminders and dispensing medication at a pre-scheduled time.

Patient health data, such as electrocardiograms and blood glucose levels, can already come from a number of connected devices as the ability to keep tabs on this type of information is vital for some. Smart devices can reduce the need for face-to-face follow-ups with physicians, which in turn could lower costs as well as enable patients to comply with instructions.

How one company is using IoT to help the physician/patient relationship

Biotricity, a developer of medical remote monitoring solutions, offers physicians a health IT solution called bioflux, composed of an electrocardiogram (ECG) monitor, software, and a monitoring lab, that targets cardiovascular disease through diagnostic and post-diagnostic care processes. The ECG device is put on the patient and constantly tracks data. Anytime the product detects arrhythmia, it transmits the ECG data from a minute before and a minute after detection to a monitoring center.

When an event occurs, a note pops up on a screen at a monitoring center saying something along the lines of “Device detecting some arrhythmia.” While the instructions are defined by the physician, the physician and monitoring center have access to the transmitted data, but the patient does not. ECG technicians at the call center will read it along with a note from the patient’s physician saying, ‘If tachycardia occurs, please call me’ or ‘Please call the patient.’

“We’re looking at a technique focused on arrhythmia detection so once you have an arrhythmia, the doctor will tell you how to manage this condition,” Biotricity CEO and founder Waqaas Al-Siddiq told Healthcare Dive. Al-Siddiq states having a complete IoT platform is crucial to monitoring for longer term care while minimizing risks, especially chronic illnesses, because as long as Internet service is available, up-to date health data can be quickly transmitted to a professional.

As always, challenges abound. Will regulations follow?

In its report, the Advisory Board Company states IoT implementation challenges in a healthcare setting include:

  • Interoperability;
  • Regulation;
  • Privacy protection;
  • Dealing with data overload;
  • Complexity; and
  • Security.

Research shows physicians already face a great deal of burden, which has been primarily attributed to administrative tasks. If an IoT platform is designed in such a way that physicians are overloaded, too much data would distract them from their mission of treating patients, Al-Siddiq says.

However, if devices and IT platforms are not compliant from a development or regulatory standpoint, potential dangers with regards to patient and privacy safety become vastly greater.

According to Al-Siddiq, regulatory integration is going to start creeping up on IoT. ABC’s Ken Kleinberg echoes this statement.

Kleinberg told Healthcare Dive some technologies are so powerful and dangerous that they will have to be regulated. “But the current trend is for government to do less regulation, not more, when it comes to IT, to not be accused of stifling innovation and holding back the economy,” he says.

Security concerns will rise alongside the Internet’s evolution

Al-Siddiq envisions the industry will begin seeing healthcare wearables 2.0 or 3.0 as patient monitoring technology becomes faster and better. They will become smaller, and could even be integrated into shirts or tattoos. More than 70 million health devices will have been adopted across the world within the next few years as new ones receive FDA approval, according to a recent study conducted by Juniper Research. Juniper Research also concluded that although interoperability with personal smartphones will become more valuable to patients, the number of individuals being monitored by devices will increase fourfold by 2020.

However, concerns remain with healthcare wearables’ vulnerability to hackers.

Each connectivity point among different healthcare technologies on an IoT platform is an opportunity for hackers to assume control over and expose private and personal information.

“It was hard to believe a few decades ago that the Internet would ever be – that so many companies, people, ideas, and competing interests and technologies could ever come together enough to exist on one useful network – one that has changed the world perhaps more than any other human advance since the printing press,” Kleinberg says.

While it may be an increasingly common topic of conversation, according to Kleinberg, IoT is still a relatively new concept so it’s too early “to see how the proliferation of so many devices, operating systems, sensors, standards, and competing interests will all work together.” However, he adds that having device connectivity across the world would be a step towards the evolution of the Internet.


With 30% of Medicare payments now tied to alternative payment models (APMs), and HHS planning to raise that percentage to 50% by the end of 2018, providers are looking for ways to increase quality of care and patient access while holding down costs. One mode that stands to gain is telemedicine, which got a boost in last year’s Medicare Access and CHIP Reauthorization Act (MACRA).

The legislation, signed into law by President Obama in April 2015, creates a 5% annual payment bonus for physicians who participate in APMs and exempts them from participating in the Merit-Based Incentive Payment System (MIPS). It specifically mentions telemedicine and remote patient monitoring as services that APMs may cover, even if those services are not reimbursed under traditional Medicare.

MACRA essentially lifts all restrictions that would otherwise exist under fee-for-service and allows doctors to utilize telemedicine and remote patient monitoring services where appropriate — offering a green field opportunity to rethink care delivery in a way that’s patient-centered and promotes care coordination and communication.

What are the options?

The American Medical Association, which has long supported telemedicine, is working to identify condition-based APM options and how telemedicine may play a role in them.

One of those options is Next-Generation Accountable Care Organizations, which went live with applications earlier this year. Unlike the Pioneer ACOs, which did not anticipate a lot of telehealth use, the next-gen ACOs feature special carve-outs and waivers and opportunities for virtual care, said Nathaniel Lacktman, a lawyer at Foley & Lardner and head of the firm’s telemedicine and virtual care practice.

Lacktman predicts that 2016 will be the year of the ACO. “I think it will hold true that a lot of them, when you check at the end of the year, will have added telehealth technologies within their existing operations,” he said. He told Healthcare Dive he would not be surprised to see some Pioneer ACOs and hospitals or health systems that have been on the sidelines of ACOs apply to become next-generation ACOs because of the telehealth opportunities.

Telehealth allows patients to connect remotely with physicians via phone or videoconference to address healthcare concerns. It has been used for years to conduct specialty consultations in rural areas, where access to doctors is more limited.

It is also convenient, allowing busy people to address health issues on the fly, rather than giving up a chunk of their day for an in-person doctor appointment.

“Where it really shines is it allows the providers to manage risk better, and because they can manage risk better they’re able to enter into capitated contracts, and that’s where the money is,” Lacktman said.

With telemedicine, you are increasing patient touches and the frequency of those touches, while remote patient monitoring allows you to be more informed about the patient’s actual state of health.

Another APM model is the Medicare Shared Savings Program (MSSP). Thanks to MACRA, MSSP now recognizes telehealth services as a clinical practice improvement activity, one of four components required to qualify for incentive payments.

Recent rule changes to the MSSP program allow physicians who provide patients with some free equipment for remote patient monitoring to be eligible for fraud and abuse waivers. An example CMS gave was a patient with high blood pressure using home telehealth to monitor their condition.

According to CMS, only 27% of MSSPs actually had cost savings and quality improvements sufficient to trigger their reward payments. But a separate study found that only 20% of MSSPs were using telehealth, Lacktman noted. While he cannot say there is a correlation, “all of the plans I work with that used telehealth technologies in 2014 received incentive payments,” he said.

Why is telemedicine become increasingly popular?

Some medical specialties, such as mental health and radiology, are well-suited, for telehealth. Another area where telemedicine is having an impact is neurology and stroke services, where consulting with a neurologist within four hours of having an event can have a huge impact on patient outcomes.

A less obvious example is the emergency department where teams of board-certified physicians in a central hub provide round-the-clock access to underserved rural hospitals via two-way video, teleconferencing, and other technologies.

Legislation now before Congress could give telehealth an even bigger push. The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, introduced in February by a bipartisan group of senators, would remove remaining Medicare barriers to use of telehealth at a projected savings of $1.8 billion over 10 years.

Under CONNECT, for example, physicians and health systems participating in APMs would be able to use remote patient monitoring for patients with chronic conditions. And it would expand use of telemedicine and remote patient monitoring in rural health clinics and community health centers. A similar bill was introduced in the House.

Telehealth payment parity is also gaining traction at the state level, with 29 states and the District of Columbia having enacted telemedicine laws. These laws are expected to drive uptake of telehealth among commercial insurers. An example is Independence Blue Cross of Philadelphia, which recently announced plans to cover telemedicine.

“Change is happening, and we know that the Medicare program drives change on the commercial side as well,” Lacktman said. “That means that it won’t just affect the people who are 65 and older. It will affect all the younger people as well.”

© 2019 Florida ACO. All rights reserved. Designed by PtScout LLC