“Together, the Medicare Payment Advisory Commission … and [Elliot] Fisher provided the impetus for the current concept and interest in acos.”


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“Together, the Medicare Payment Advisory Commission … and [Elliot] Fisher provided the impetus for the current concept and interest in ACOs.”

  • “Together, the Medicare Payment Advisory Commission … and [Elliot] Fisher provided the impetus for the current concept and interest in ACOs.”

  • Kelly Devers and Robert Berenson, “Can Accountable Care Organizations improve the value of health care by solving the cost and quality quandaries?” Urban Institute, October 2009, P 2 http://www.urban.org/publications/411975.html, accessed February 3, 2011.



“The report must discuss disaggregating the current … [Sustainable Growth Rate method of updating the Medicare physician fee schedule] target into multiple pools using five alternatives: Group practice, hospital medical staff, type of service, geographic area, and physician outliers.”

  • “The report must discuss disaggregating the current … [Sustainable Growth Rate method of updating the Medicare physician fee schedule] target into multiple pools using five alternatives: Group practice, hospital medical staff, type of service, geographic area, and physician outliers.”

  • Statement of Dana Kelly, transcript of Medpac’s October 5, 2006 meeting, P 3, http://www.medpac.gov/transcripts/10_06_MEDPAC_all.pdf , accessed February 8, 2011.



“Let me briefly describe the general approach we've taken to assigning patients. If a physician works in an inpatient setting, we assign them to the hospital where they provided care to the greatest number of Medicare beneficiaries [they] saw. If they get no inpatient work, we assigned him to the hospital where the plurality, or actually the majority in most cases, of their patients they billed for were admitted…. It turns out, not surprisingly, that you can assign virtually all physicians billing Medicare to a hospital.”

  • “Let me briefly describe the general approach we've taken to assigning patients. If a physician works in an inpatient setting, we assign them to the hospital where they provided care to the greatest number of Medicare beneficiaries [they] saw. If they get no inpatient work, we assigned him to the hospital where the plurality, or actually the majority in most cases, of their patients they billed for were admitted…. It turns out, not surprisingly, that you can assign virtually all physicians billing Medicare to a hospital.”

  • Testimony of Elliot Fisher to Medpac, November 9, 2006, PP 287-288, http://www.medpac.gov/transcripts/1108_1109_medpac.final.pdf, accessed February 5, 2011.



Doctor who treats 40 patients in Hospital A, 30 in Hospital B, and 30 in Hospital C is assigned to Hospital A.

  • Doctor who treats 40 patients in Hospital A, 30 in Hospital B, and 30 in Hospital C is assigned to Hospital A.

  • Doctor who does no inpatient work is assigned to the hospital where a plurality of his patients were admitted. Thus, doctor who treats 40 patients admitted to Hospital A, 30 admitted to hospital B, and 30 admitted to Hospital C, is assigned to Hospital A.



Elvis Presley appeared in “Change of Habit” (1969) with Ed Asner;

  • Elvis Presley appeared in “Change of Habit” (1969) with Ed Asner;

  • Ed Asner appeared in “JFK” (1991) with Kevin Bacon;

  • Therefore, Asner has a Kevin Bacon number of 1, and Presley has a Bacon number of 2.

  • Wikipedia, http://en.wikipedia.org/wiki/Six_Degrees_of_Kevin_Bacon, accessed February 5, 2011.



“Thank you Elliot. As always, a great job. [P 308]….The third notion that interests me is within such a framework of total cost and geography creating opportunities for what I'll call accountable organizations to get their own performance assessment. So if you have a geographic system the target would still be the target for the geographic region. But as opposed to their payment consequences being based on the whole region's performance, it could be for a smaller subset like an extended hospital medical staff….” [P 309]

  • “Thank you Elliot. As always, a great job. [P 308]….The third notion that interests me is within such a framework of total cost and geography creating opportunities for what I'll call accountable organizations to get their own performance assessment. So if you have a geographic system the target would still be the target for the geographic region. But as opposed to their payment consequences being based on the whole region's performance, it could be for a smaller subset like an extended hospital medical staff….” [P 309]

  • Statement of Glenn M. Hackbarth, Medpac meeting, November 9, 2006, http://www.medpac.gov/transcripts/1108_1109_medpac.final.pdf, accessed February 5, 2011



“I love your notion of accountable organizations. It's exactly the right thing we want to create. And I agree completely with applying it to all services. It should include the whole gamut of care so we get rid of the silos, because you look at the numbers of care transitions and you just see that these places are churning patients from hospital to acute care to nursing home back to the hospital.”

  • “I love your notion of accountable organizations. It's exactly the right thing we want to create. And I agree completely with applying it to all services. It should include the whole gamut of care so we get rid of the silos, because you look at the numbers of care transitions and you just see that these places are churning patients from hospital to acute care to nursing home back to the hospital.”



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