Download Slides Join us for a session built for ACO leaders who want the real story behind their performance numbers – no polite webinar energy, just candid, occasionally unhinged takes on what’s actually going on in your reporting. David Klebonis, President & COO of Palm Beach Accountable Care Organization, has lived inside MSSP reporting…
Download Slides Healthcare data is notoriously siloed across Electronic Health Records (EHRs), claims databases, and pharmacies. Capturing a complete longitudinal patient record is highly challenging, yet entirely achievable. The main obstacle is that raw data is rarely enough; medical records vary widely due to inconsistent workflows, and even common procedures like a colonoscopy surface…
Dive Insight: CVS is the latest in a growing list of insurers turning to the courts in a bid to hike their 2027 MA star ratings, after the quality scores slipped for many operators, threatening the lucrative bonus payments and other competitive advantages the ratings represent. To date, at least four other insurers — Alignment Healthcare, Healthfirst,…
Download Slides CMS is rewriting the ground RPM and CCM programs stand on, from new billing rules to an entirely new payment model in the ACCESS program. Organizations running these programs today are planning around rules that are still moving. Dr. Beau Muñoz, Director of Medical Affairs at Pearl Health, joins Mark Aspenson, CEO…
In a clinically integrated network where nearly 70% of primary care physicians are independent, leaders cannot rely on a traditional management structure to drive change. Physician governance and trusted data become essential to engagement and to whether AI-powered insights earn clinicians’ confidence. In a featured session sponsored by Arcadia and Navvis at Becker’s 11th Annual…
Download Slides New Medicaid community engagement requirements are approaching, and for health plans, preparation extends well beyond understanding the policy. Under CMS’s current framework, certain Medicaid adults will be required to meet community engagement requirements or qualify for an exemption, with states generally required to implement the new requirements by January 1, 2027. When…
To appropriately hold participants accountable for population outcomes, value-based payment models must account for the factors that drive variation in outcomes outside of participant performance. over time, there has been growing recognition that beyond clinical factors, social and economic conditions can play a role in shaping variation of population outcomes that are targeted by value-based…
As CKCC nears its sunset, kidney care leaders urge CMS to preserve a dedicated, nephrologist-led accountable care model for advanced kidney disease. In 2027, Medicare will enter an important transition in its continued evolution toward accountable care. The Long-term Enhanced Accountable Care Organization Design (LEAD) Model will begin a 10-year test intended to make accountable…
Reducing health care spending and improving population health needs a comprehensive approach to replace the current fragmented silo-based approaches. Thoughtful program designs with financial incentives and clear metrics have demonstrated that health care can be delivered at lower cost with similar or better outcomes than currently. Yet significant obstacles remain: Underinvestment in primary care and…
National Association of ACOs hosts leader at fall conference. Accountable care organizations (ACOs) are the best way to deliver health care, the nation’s Medicare chief said. Now federal health leaders and ACO participants must join to recruit practices that are not in an accountable care model. Centers for Medicare & Medicaid Services Administrator Mehmet Oz,…
CMS released 2027 Medicare Advantage star ratings on Oct. 8, giving more insight into the MA landscape beyond health plans’ marketing materials. Contracts receive a rating each year, ranging from one to five stars. The ratings help beneficiaries compare plans, but they also shape quality bonus payments to boost benefits. Four stars is the main…
The Centers for Medicare and Medicaid Services (CMS) is advancing an initiative that proposes to expand access to GLP-1s for the Medicare population: the Medicare GLP-1 Bridge short-term demonstration program. Overview of the Medicare GLP-1 Bridge demonstration program CMS introduced the Medicare GLP-1 Bridge demonstration program as a short-term initiative to expand access to GLP-1…