The end of each calendar year brings with it an atmosphere of heightened scrutiny for risk-bearing health care organizations. These organizations are in a race against time to close risk and quality gaps to maximize their performance and reimbursements in value-based care (VBC). The upcoming Healthcare Quality Week is a timely reminder for organizations to…
While the need to address social determinants of health (SDOH) is definitely not new, 2023 marks the first year SDOH is codified into national and statewide value-based payment program mandates. These mandates are designed to hold Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs) accountable. While the rollout of SDOH code sets across our…
Download Slides New HCC model keeping you up at night? Here’s how to prep. The V28 transition will be critical to your 2024 strategy. And with big changes there are questions: Are coders prepared for the massive HCC code changes? How will the changes impact our populations risk scores? And what does that mean…
Dive Brief: The CMS agency that tests value-based payment models hopes to announce two new models in behavioral health and maternal health later this year, according to Liz Fowler, director of the Center for Medicare and Medicaid Innovation. Both upcoming models have “a heavy role” for the Medicaid program, Fowler said Thursday during a Health…
Are you spending too many resources chasing charts? The answer is probably yes. Validating diagnoses for members is critical to success for any risk adjusted population, and retrieving and coding charts is the most popular process used to tackle this issue. While chart chasing can be helpful, there are inefficiencies that can be a burden….
Download Slides Medicaid expansion is putting pressure on states, providers and plans to drive down costs. States want to limit exposure by signing full-risk contracts with health plans and provider systems. How can you meet new requirements and secure your spot in the market? In this webinar, ATTAC Consulting Group will share expert insights…
CMS has unveiled a new payment model aiming to support health equity in the states by shifting health care to community-based settings. The agency is already addressing health equity in other models, such as Enhancing Oncology Model and ACO REACH. The States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model) aims to better…
Download Slides ( REGISTER NOW FOR PART 2 ON 10/5/23 @ 1PM EST: CLICK HERE!! ) This webinar is the first of a two-part series which examines the different types of risk provider organizations may face and different ways to mitigate its impact. The first session in the series focuses on building a base…
Healthcare is hard. While the American healthcare industry is filled with complexity as it seeks to interweave between multiple care delivery settings, care providers, and payment mechanisms – it points out the obvious that many new entrants into the industry experience: Making changes in healthcare and obtaining winning results is hard. With Medicare as typically…
The shift toward value-based care (VBC) is increasingly taking hold in health care as practices continue to face challenges with stagnant fee-for-service reimbursement rates and medical cost inflation. To succeed in a VBC environment, practices must adopt patient engagement as a foundational capability. Better patient engagement not only helps keep patients healthy and from needing higher-cost…
Download Slides Wasted healthcare spending due to ED overutilization continues to rise, with a 51% increase in spend from 2012-2019. Health organizations continue to pour money and resources into ED diversion initiatives, but despite best efforts, utilization is at an all-time high with nearly 1 in every 3 ED visits categorized as avoidable or…
Quality issues are still the number one reason for drug shortages, and in an effort to address this, the U.S. Food and Drug Administration is debuting a quality management maturity (QMM) program intended to incentivize drugmakers to invest in quality measures. The program will be run by the FDA’s Center for Drug Evaluation and Research…