This week, a group of senior officials from the Centers for Medicare and Medicaid Services (CMS), some from the Center for Medicare, some from the Center for Medicare & Medicaid Innovation (CMMI, also called The Innovation Center) authored an op-ed in the Perspectives section of The New England Journal of Medicine online, in which they outline their…
Nathan Moore, M.D., medical director of the BJC Medical Group ACO in St. Louis, sees annual wellness visits (AWVs) as a scaffolding for all of the ACO’s improvement efforts. “We’re using this as our point of entry for advanced care planning and for functional status evaluations,” he said. Moore was speaking during an April 28…
Value-based payment models that shared five-year expected savings offered stronger incentives for clinicians to implement preventive interventions for postpartum depression compared to models that offered shared savings over just one year, according to a study published in JAMA Network Open. The Affordable Care Act requires most commercial health insurance plans to cover preventive services for pregnant or postpartum…
For Morgan Honea, CEO of CORHIO (a Contexture organization), the value of interoperability between healthcare and dental settings revealed itself during his earlier career running federally qualified health centers (FQHCs). “I’ve spent most of my career integrating primary, oral, and behavioral healthcare in a service delivery setting,” Honea told EHRIntelligence in an interview. “There are so many medical…
Data standards and community stewardship are critical elements for social determinants of health (SDOH) data exchange, according to Greg Bloom, strategic advisor on community resources and engagement for the Gravity Project, a community-led HL7 Fast Healthcare Interoperability Resources (FHIR) Accelerator. The Gravity Project worked with healthcare stakeholders such as health IT vendors, payers, providers, philanthropies,…
Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage continues to demonstrate that it offers important cost protections and value for Medicare Advantage beneficiaries,” said Allison Rizer, principal at ATI Advisory…
Download Slides One of the biggest hurdles for value-based care is motivating patients to adopt healthier lifestyles and adhering to care plans – for the long term. Contrary to popular belief, it’s NOT enough to just inform and educate patients, especially those with chronic conditions. We already provide patients with plenty of well-designed handouts…
The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus the…
Loneliness and social isolation rose alarmingly during the COVID-19 pandemic as lockdowns proliferated and in-person gatherings were discouraged. A critical social determinant of health (SDOH), social isolation is estimated to have increased by 6.7 percentage points during the pandemic. To help combat this and other SDOH issues, providers and payers are turning to data analytics. Several companies have…
The Center for Medicare and Medicaid Innovations (CMMI) recently announced the ACO Realizing Equity, Access, and Community Health (REACH) Model. The REACH Model will replace the Direct Contracting model starting on 1/1/23. ACO REACH retains the DC Model Global and Professional tracks and adds new requirements to advance equity, promote provider governance, and protect beneficiaries….