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Overcoming 5 Leading Obstacles to Achieving Racial Health Equity

February 22, 2023Garrett Schmitt

The medical industry is far from achieving racial health equity, according to a new report from Accenture. But it could be. The report, which outlines some of the stark racial health disparities still plaguing the US, also looks at the barriers keeping the nation from confronting its problems and a roadmap for mitigating these issues….

Why Disney shifted to a value-based care model for its 77,000 Florida employees

February 22, 2023Garrett Schmitt

Healthcare prices are on the rise, and in a system already notorious for its lack of affordability, many employers are nervous about what this means for their employees’ health. But instead of taking a wait-and-see approach, some employers have decided to change the way they provide healthcare altogether. Business Group on Health, a nonprofit organization…

15 things to know about ACO REACH

February 21, 2023Garrett Schmitt

The ACO Realizing Equity, Access, and Community Health model is the latest shared-savings model designed by CMS to improve care and reduce costs in traditional Medicare. Several of the largest payers are stepping further into value-based care by acquiring and expanding provider organizations. Here are 15 things to know about the ACO REACH model… Full…

AMGA Calls on Congress to Advance Value-Based Care, Support Providers

February 21, 2023Garrett SchmittAdvanced APM, AMGA, APM, APMs, COVID, COVID-19, remote patient monitoring, RPM, Telehealth

Congress should focus on advancing value-based care by investing in proper infrastructure, incentivizing patient engagement, and supporting continuous telehealth coverage, according to the American Medical Group Association (AMGA). The organization sent a letter to congressional leaders expressing appreciation for their efforts to support healthcare providers throughout the COVID-19 pandemic. However, the letter urged leaders to improve the Medicare program…

Optum study: Accountable Medicare Advantage models produce better outcomes, greater efficiency

February 17, 2023Garrett Schmitt

Value-based models in Medicare Advantage (MA) achieve better patient outcomes and more efficient care compared to traditional Medicare, according to a recent study from Optum. The study, which was published in JAMA Network Open, included data on more than 316,000 people, split evenly between MA members in a two-sided risk accountable care model and traditional Medicare…

ACO Benchmarks Based On Area Deprivation Index Mask Inequities

February 17, 2023Garrett Schmitt

The evidence of the disproportionate impact of the COVID-19 pandemic has galvanized calls for change and a renewed determination by local, state, and national regulatory bodies to make health care more equitable and reduce the long-standing disparities in health outcomes. The disproportionately detrimental effect on the health and well-being of various patient groups is not…

Patient Engagement Is Once Again Top Of Mind. What’s Different This Time?

February 16, 2023Garrett SchmittACO participation, digital patient experience, digital SDOH, MSSP, MSSP ENHANCED, Patient Engagement, Telehealth

As 2023 dawns, strategic conversations in health care are shifting away from the pandemic’s “crisis mode” to refocus on addressing long-term needs and opportunities to improve patient outcomes. Patient engagement is an area that is consistently discussed as ripe for evolution. In an ideal world, every health care provider would be focused on patient engagement…

Multi-million dollar opportunities (and risks) with PY 2024 decisions

February 16, 2023Garrett Schmitt

For PY 2024, the process ACOs use for making their annual model, track, and participant selections should be modified to include several recently announced regulatory changes.  Foremost among them is a new multimillion dollar decision: Whether to early renew to take advantage of the MSSP methodology changes defined in the 2023 Medicare Physician Fee Schedule…

Policy Brief: Applying Risk Adjustment Caps in an Equitable Manner

February 16, 2023Garrett Schmitt

Accountable care organizations have demonstrated success in improving quality of care for patients, including underserved and vulnerable individuals, while saving $13.3 billion in gross savings and $4.7 billion in net savings to Medicare in the past decade. The Centers for Medicare and Medicaid has set a goal of having all beneficiaries in accountable care models…

Medicare Advantage Advance Notice: An Overview of the High-Impact Proposed Changes

February 16, 2023Garrett Schmitt

On February 1, 2023, CMS released the Medicare Advantage (MA) Advance Notice which is a document used to give notice to MA plans about upcoming changes to the model for the following performance year. MA plans are given a period of time in which they may submit comments on the proposed changes. In early April…

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