In February 2022, the Centers for Medicare & Medicaid Services (CMS) announced ACO REACH, extending the Direct Contracting model to better align with CMS’ strategic initiatives. In this new model, CMS introduced many significant changes to achieve the goals, after which REACH is named – Realizing Equity, Access, and Community Health. Specifically, CMS implemented five…
It is early 2018, and Cigna announced its acquisition of Express Scripts, CVS Health recently announced its acquisition of Aetna, Humana its 40% ownership stake in Kindred[1], and Optum recently announced its DaVita Medical Group (formerly HealthCare Partners) acquisition. It was a mad rush to find assets or become buyer targets for each of the…
Accountable care organizations are urging Congress to extend a dependable bonus payment to physicians that has been used to improve quality of care, advocates say. The 5% payment supports participants in alternative payment models who meet quality goals, and is set to expire in 2023. The money goes directly to physicians, incentivizing them to join…
Download Slides Challenges around time, money and transportation can have a noticeable impact on a wide range of health risks and the outcomes associated with those risks. In the fight against diabetic retinopathy, shared care programs that address these challenges head-on can make a difference. Join us to discuss a real-life example of a…
In 2019, 48 percent of Medicare-Medicaid dual-eligible beneficiaries identified as being from a racially/ethnically minoritized group, while only 21.6 percent of Medicare-only beneficiaries were from racially/ethnically minoritized groups. Since 2006 the percent of dual-eligible beneficiaries from racially/ethnically minoritized groups has grown by 19.2 percent, and we can expect this growth to continue as our population…
Medicare’s Shared Savings Program (MSSP) saved CMS $1.66 billion in 2021, marking the fifth consecutive year of overall savings for the program; however, savings from performance year 2021 represent a decline from 2020, when ACOs saved Medicare $1.9 billion. The 475 participating ACOs compromising half a million clinicians provided service to 11,000,000 Medicare patients, with…
More often than not, ground-breaking health care advancements are disproportionately accessible for those who already have favorable social determinants of health. Improving cost, access, and quality, but for whom? The boom of telehealth and digital health during the pandemic was a necessary shift to bridge the critical access gap while also supporting the public health…
Are accountable care organizations (ACOs) potentially creating financial savings by neglecting or limiting care for serious mental illness (SMI)? A team of researchers has examined the issue for an article in Health Affairs. Based on their analysis, it appears that such is not the case; but there is complexity, which the researchers explore in their…
Closed loop communication is a defined strategy that’s frequently used in complex environments, such as acute care settings, to reliably exchange critical information quickly and concisely. With this technique, an individual shares information with another person and the receiver repeats the information back and asks any follow-up questions to gain clarity. The person initiating the…
“We shall have no better conditions in the future if we are satisfied with all those which we have at present. ― Thomas A. Edison Value-based care (VBC) and population health management (PHM) will be impacted for years to come as a result of the COVID-19 pandemic. There is little doubt that COVID-19 brought about…