Healthcare providers are continuing to form and invest in Accountable Care Organizations (ACOs) as a means of improving care quality and reducing costs. Some of the largest ACOs serve upwards of hundreds of thousands of patients, while, overall, 13.7 million Medicare beneficiaries are being cared for by ACOs this year, according to the Centers for…
As opportunities to provide palliative care through Accountable Care Organization (ACO) relationships continue to arise, operators will likely need to understand the varying types of reimbursement that exist in that arena. ACOs are groups of physicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients….
Better relationships between payers and providers will be key to developing successful value-based initiatives that benefit patients while addressing the concerns of both stakeholders, according to panelists at the Community Oncology Alliance (COA) Payer Exchange Summit. The panel discussion highlighted the ongoing challenges and opportunities for payers and providers to collaborate on innovative, data-driven value-based…
Forty years ago, at the height of the AIDS epidemic, HIV researchers and physicians discovered that simply treating the symptoms of the disease was not enough to provide lasting improvement for patients. Other factors like unstable living conditions, drug use, the public stigma over AIDS and HIV – known today as social determinants of health…
For ACOs to remain relevant as leaders of Value-Based payment models, they must step up now to generate more cost savings for Medicare patient care. Budget cuts for Medicare are once again under discussion by conservatives as political pressure mounts to lower governmental spending. Meanwhile, CMS is expanding risk in Medicare value-based payment models, moving…
Institutional Special Needs Plans could be the tool nursing homes need to find better clinical and financial success and help the government achieve its goals of reducing costs and improving quality, a trio of researchers and policy advisors argues in the New England Journal of Medicine. But more data is needed to determine whether the…
Disruptive reimbursement and regulatory challenges are top of mind for today’s hospice c-suite executives, who recently sat down with Hospice News to discuss what they see as the largest hurdles to sustainable end-of-life care delivery. Reimbursement pressures and changes among the most significant concerns for today’s hospices, according to Kristen Yntema, president and CEO of…
As physicians in practice become more and more burdened by administrative work, they’re finding that those burdens are impacting their sense of their effectiveness in patient care delivery. As a result, many medical group leaders are seizing the opportunity to implement artificial intelligence tools that their physicians can use. For example, AI can be leveraged…
A new study has found that Medicaid ACOs in Massachusetts were associated with increases in prenatal and postpartum office visits, postpartum depression screenings, and timely postpartum care. Despite recent declines in nationwide maternal mortality, the United States continues to experience a significant maternal health crisis, in part shaped by inequitable access to quality health care…
“How can we advance health equity in cardiovascular care?” asked David Thompson, PhD, professor of nursing, School of Nursing and Midwifery, Queen’s University Belfast, Northern Ireland, on day 2 of the 2024 European Society of Cardiology Congress. To even know where to begin, it’s important to first understand that health equity and health equality are…
Physicians working with value-based payment models are being graded on an average of 57 different quality measures a year, according to a new study. The quality measures were included in commercial and government insurance plans, with Medicare leading the number, with 15.04 quality measures per contract in 2022, according to “Value-Based Contracting in Clinical Care,”…
I was the editor of a healthcare business magazine for 11 years. I was in charge of hiring and firing our editorial staff of reporters, editors and designers. My performance measures for new hires were pretty simple: get to work on time, work hard, do a good job, don’t cause any trouble and leave on…