Gabe supports clients with their acute, post-acute, and long-term care policy and strategic goals. Gabe’s expertise encompasses value-based care, accountable care organizations, bundled payments, and the Medicare Access and CHIP Reauthorization Act of 2015.Prior to joining Avalere, Gabe interned with the Alliance of Community Health Plans, performing health insurance and ACA initiative research and conducting market analysis. Prior to that, as an intern at Costs of Care, he was responsible for building social media presence and outreach to healthcare professionals. In addition, he was a contributor to the organization’s website and wrote for the Costs of Care and HealthWorks Collective.Gabe has a BA from Brandeis University.
Gabe Sullivan supports clients with research and analysis that span a variety of healthcare sectors and stakeholders.
Tune into the ninth episode of our podcast series, Get the Facts on COVID-19. In episode 9, Avalere experts from the Health Plans and Providers practice and the Center for Healthcare Transformation discuss the near- and long-term impacts of COVID-19 on value-based contracting and Alternative Payment Models (APMs). The conversation focuses on Medicare programs, such as specialty Accountable Care Organizations (ACOs) and bundled payment models, and newer Center for Medicare and Medicaid Innovation (CMMI) programs.
Avalere’s analysis found that hospice patients diagnosed with cardiovascular and dementia conditions represent the largest proportion of “live discharges” compared to patients with other conditions.
Avalere’s findings were featured in the Journal of Parenteral and Enteral Nutrition.
New analysis from Avalere finds that more accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) have assumed downside risk as the program matures, with the greatest growth over the past 3 years.
New analysis from Avalere finds the proposed case-mix adjustment for the radiation oncology model underestimates payments for prostate cancer .
Medicare ACOs continue to realize experience-level results.
Providers in the Bundled Payments for Care Improvement Advanced initiative began to assume financial risk on March 1, 2019.
ACO Experience Again Proves to Be an Indicator of Success
The majority of hospitals in BPCI Advanced, the second iteration of CMS’ largest bunded payment initiative, have no prior experience with risk in the original BPCI program.
Assuming risk appears to be a less important factor than experience in predicting ACO success.
Early adoption and participation in an AAPM can provide a higher incentive payment to Medicare clinicians than MIPS.
On January 18, 2017, the Centers for Medicare & Medicaid Services (CMS) announced the new Accountable Care Organization (ACO) participants in the Medicare Shared Savings Program (MSSP) for 2017.
HHS confirms continued movement away from traditional FFS payments, yet significant work remains to move more providers away from upside-risk models and into downside-risk models.
The Centers for Medicare & Medicaid Services (CMS) announced that 121 new Medicare Accountable Care Organizations (ACOs) have joined the Medicare Shared Savings Program (MSSP) and Next Generation (Next Gen) ACO models. In addition, 147 MSSP ACOs renewed their contracts. The increase in risk-bearing ACOs and the recently released proposed benchmark rule mark CMS' commitment to shifting from volume to value.