Oncology practices that participated in two-sided risk in the latter half of the Oncology Care Model (OCM) were the main driver of payment reductions in the model, according to an evaluation prepared for the Center for Medicare & Medicaid Innovation. In February 2015, the Centers for Medicare & Medicaid Services (CMS) invited oncology physician group…
Carle Health, a vertically integrated health system, and Lumeris, a leading value-based care enablement company, today announced a strategic partnership to improve healthcare delivery and patient outcomes through value-based care for communities in Central Illinois. The partnership will transform care delivery for Medicare populations by integrating Lumeris’ comprehensive technology solutions and population health management tools…
On Tuesday, Nov. 19, President-elect Donald Trump announced that he would nominate Mehmet Oz, M.D., to be the next Administrator of the Centers for Medicare & Medicaid Services (CMS). POLITICO’s Ben Leonard wrote on Tuesday afternoon that “President-elect Donald Trump has chosen Mehmet Oz, the celebrity physician and TV personality known as Dr. Oz, to…
Health insurance plans are seeing continued growth in the adoption of value-based care arrangements and shared risk arrangements, according to the 2024 annual survey by the Health Care Payment Learning & Action Network (HCPLAN). The HCPLAN is a group of public and private healthcare leaders dedicated to providing thought leadership, strategic direction, and ongoing support…
The recent CMS results for the Medicare Shared Savings Program (MSSP) showed record-breaking savings—over $2.1 billion in 2023. Yet, not all ACOs achieved these gains. So, what separates the high performers from those that struggle to meet savings goals? The answer lies in strategic focus, effective coordination, and the intelligent use of data. This blog…
Dallas Nephrology Associates (DNA), the largest nephrology practice in Texas, has received national recognition for a revolutionary new practice model that has improved patient care and could save payors millions of dollars. DNA has participated in several projects with Medicare that has already resulted in millions of dollars in savings to the agency. Nephrology is…
At a time of major change and great uncertainty in U.S. healthcare, the leaders of state hospital associations are doing everything possible not only to ensure the survival of the hospitals and health systems that are their members, but also to work to create and strengthen their bonds with their communities. One of those associations…
In an annual survey of Medicaid managed care plans, data sharing challenges and provider readiness or willingness to participate in alternative payment models continue to be significant barriers, The Institute for Medicaid Innovation’s (IMI) annual Medicaid managed care survey is an effort to collect robust, longitudinal data on Medicaid managed care organizations (MCOs) across the…
Providers across the nation are continuing their work to make value-based care at scale a reality. One of the most recent examples of this comes from Emory Healthcare in Atlanta — on Monday, the health system announced a partnership with Dallas-based startup Guidehealth designed to help value-based primary care reach more than 350,000 patients across…
The Medicare program is approaching a “tipping point” on its journey to move all beneficiaries into value-based care arrangements, but policymakers, health systems and insurers need to do more to convince reluctant providers to get involved, a panel of experts said Thursday. The Centers for Medicare & Medicaid Services in 2021 set a goal of…
What You Should Know: – State of Franklin Healthcare Associates (SOFHA), the largest employee-owned, physician-led multi-specialty primary care group in the nation, has announced a new partnership with Lumeris, a leading value-based care enablement company, to improve healthcare delivery and outcomes in Northeast Tennessee and Southwest Virginia communities beginning in 2025. – By combining SOFHA’s exceptional provider…
Remote physiological monitoring (RPM) and chronic care management (CCM) are well-established programs with years of operational and billing experience in many practices. These billable activities have allowed health care providers to offer more comprehensive care to Medicare beneficiaries outside of their traditional in-person doctor’s visits. Because the U.S. Centers for Medicare & Medicaid Services (CMS)…