1/19/2024 0 Comments Pi1000 svatThe views expressed here do not necessarily reflect the views of the Foundation or of MedPAC. Introductionīroad consensus has long existed among public- and private-sector leaders in US healthcare that improvements in healthcare affordability will require, among other changes, a shift away from fee-for-service (FFS) payments to alternative payment models that reward quality and efficiency. The alternative payment model that has gained broadest adoption over the past ten years is the accountable care organization (ACO), in which physicians and/or hospitals assume responsibility for the total cost of care for a population of patients. Launched by the Centers for Medicare & Medicaid Services (CMS) Innovation Center in 2012, Pioneer ACO was the first such model design to generate savings for Medicare. In this incarnation, Medicare set a benchmark for total cost of care per attributed ACO beneficiary: If total cost of care was kept below the benchmark, ACOs were eligible to share in the implied savings, as long as they also met established targets for quality of care. If total cost of care exceeded the benchmark, ACOs were required to repay the government for a portion of total cost of care above the benchmark. Payment models similar to the one adopted by Pioneer ACOs also have been extended to other Medicare ACO programs, with important technical differences in estimates for savings and rules for the distribution of savings or losses as well as some models offering gain sharing without potential for penalties for costs exceeding the benchmark. State Medicaid programs as well as private payers (across Commercial, Medicare Advantage, and Medicaid Managed Care) also have adopted ACO-like models with similar goals and payment model structures. Of the roughly 33 million lives covered by an ACO in 2018, more than 50 percent were commercially insured and approximately 10 percent were Medicaid lives. 2 Health Affairs Blog, “Recent progress in the value journey: Growth of ACOs and value-based payment models in 2018,” blog entry by Muhlestein D et al., August 14, 2018. On the whole, ACOs in the Medicare Shared Savings Program (MSSP) have delivered high-quality care, with an average composite score of 93.4 percent for quality metrics. However, cost savings achieved by the program have been limited: ACOs that entered MSSP during the period from Januto December 31, 2014, were estimated to have reduced cumulative Medicare FFS spending by $704M by 2015 after bonuses were accounted for, net savings to the Medicare program were estimated to be $144M. Gang Beasts is a multiplayer party game developed by Boneloaf and published by Double Fine Presents.ģ McWilliams JM et al., “Medicare spending after 3 years of the Medicare Shared Savings Program,” NEJM, 2018, Volume 379, pp. Originally released in 2014, the game has gained popularity for its wacky and hilarious gameplay. In Gang Beasts, players control jelly-like characters, known as "beasts," who fight each other in various environments. In Gang Beasts for Windows, players can choose to play with friends in local or online multiplayer modes. The game features a variety of levels, each with their own unique challenges and obstacles. The goal of the game is to knock out opponents by punching or throwing them out of the level. The gameplay mechanics of Gang Beasts for Windows are based on physics and are focused on players fighting against each other in various environments. Here are some of the key gameplay mechanics of Gang Beasts:Ĭharacters: Players control jelly-like characters known as "beasts." Each character can be customized with different colors and costumes.Ĭontrols: Gang Beasts has simple and intuitive controls that make it easy for players to pick up and play. The game is played using a gamepad or keyboard, and each button is assigned to a specific action, such as punching, kicking, grabbing, and throwing. Physics: The game's physics-based mechanics mean that players need to take into account their characters' momentum, weight, and balance when fighting. This adds an element of strategy to the game as players need to figure out the best way to knock out their opponents. Moves: Gang Beasts features a range of different moves, including punches, kicks, throws, and grabs. Players can also climb and crawl on different structures in the game's environments.Įnvironments: The game features a variety of levels, each with their own unique challenges and obstacles.
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