Interoperability in healthcare, it would seem, is at an important inflection point. Rules around data exchange have been around for years, and regulate what patient information gets shared between payers, providers and the patients themselves. There are also standards around how that information is shared, and the forms it can take. But the transition to…
Given the wide expansion of value-based payment (VBP) models in the United States, VBP can be a useful tool for reducing health inequities and advancing equity goals. VBP models provide more flexibility to address social drivers of health (SDoH); they provide services and care coordination that are not typically covered but may be particularly important…
April marked the 10-year anniversary of the start of the agreement period for the first Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) – an ambitious program to reward health care providers for improving health care for people with Medicare. The program now includes 483 ACOs with over 525,000 participating…
Increasingly, healthcare organizations are starting to design social determinants of health screening processes. Coming as a response to value-based care trends, social determinants of health screenings help clinicians and organization leaders understand the social issues affecting the health and wellness of the organization’s unique patient population. Those insights can inform the community health partnerships the…
Download Slides In today’s value-based care landscape, growth and success may appear different for each organization. Market conditions, resources and budgets, company goals – each of these play a role in determining the go-to-market strategy. To truly understand and define these areas, you need to first start by looking at your performance insights. …
By 2025, accountable care organizations will be required to do quality reporting via electronic clinical quality measures (eCQMs). Maria Alexander, senior director of population health at Mount Sinai Health System in New York, recently spoke about the pros and cons of reporting via eCQMs during the voluntary transition period between now and then. The Centers…
In recent years, momentum among Accountable Care Organizations (ACOs) to improve health equity has increased. The Centers for Medicare & Medicaid Services’ announcement of the redesigned ACO REACH contracting model to improve health equity will only accelerate this momentum. In this blog, we will help ACOs and healthcare payers understand how healthcare analytics can be used to identify health equity challenges…
Championed by government entities like the Centers for Medicare and Medicaid Services and the Department of Health & Human Services, value-based care is here to stay. Hospitals are increasingly participating in value-based programs—such as the Hospital Readmissions Reduction Program and Bundled Payments for Care Improvement—in an effort to improve care delivery and patient outcomes while…
As the medical industry continues to understand how social determinants of health impact overall wellness, the topics of environment and climate change have come into view. SDOH specifically refer to the environments in which individuals live, work, and play. Currently, most stakeholders are zooming in on factors like houselessness or food insecurity as leading SDOH…
In the opening session of this year’s National Association of Accountable Care Organizations (NAACOS) Spring Conference, NAACOS president and CEO Clif Gaus, ScD, moderated a discussion with Rob Fields, MD, MHA, chief population health officer at Mount Sinai Health System, and Meena Seshamani, MD, PhD, deputy administrator and director, Center for Medicare,, CMS. Throughout the session,…
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. These value-based…
The Biden administration wants to change how benchmark payments to accountable care organizations are calculated to make it easier for providers in the Medicare Shared Savings Program (MSSP) to qualify for savings. Leaders in the Centers for Medicare & Medicaid Services (CMS) outlined several changes they are pursuing to get more providers involved in value-based…