People who qualify for Medicare and Medicaid on the basis of a combination of low-income status and age, disability, or end-stage renal disease, also known as dual eligibles, remain a focus of research and policy making because of their complex insurance coverage and high health care costs. Nationally, there are approximately twelve million dual eligibles:…
Social determinants of health (SDOH) are associated with severe visual impairment (SVI), according to a study published in JAMA Ophthalmology. Employment status, socioeconomic status, race and ethnicity, and health care coverage all correlated with higher odds of SVI. There are 32 million Americans who have reported blindness or difficulty seeing despite glasses or contact lens…
Research supports what most Americans understand intuitively: A person’s health is strongly linked to where they live, learn, work and play. These variables, often stratified by race, are known as social determinants of health (SDOH), and they include everything from education and employment to food, transportation and safety.1 To see SDOH in action, consider that during…
The final rule for 2023 Medicare Physician Fee Schedule (MPFS) was released November 1, 2022. It will have the biggest impact on your ACO’s financial opportunities and downside risk exposure since the introduction of the Pathways to Success program. The changes are significant enough that this rule can be thought of as the third generation…
CareJourney and Koda Health today announced new findings on the adoption rate of Advance Care Planning (ACP)1, using Medicare claims and enrollment data from 2015 to 2019.2 Overall, adoption rates of ACP are sluggish, with significant disparities across race and dual-status between Medicare Advantage (MA) and Fee-for-Service (FFS) beneficiaries. However, Accountable Care Organizations (ACOs) are administering…
Download Slides Patty Starr at Health Action Council sums it up: “Health literacy is key to lowering healthcare costs and better digital education is your key to unlocking health literacy.” As pressure mounts to fulfill Value-Based Care initiatives, health systems and ACOs can proactively shift focus to improve health literacy for patients and the community they serve or risk…
The CMS is making changes to Medicare’s accountable care organization program in an effort to jumpstart participation that has recently plateaued, the agency said in its final 2023 Physician Fee Services payment rule released Tuesday. Beginning in January 2024, ACOs that don’t have experience with performance-based risk will be able to stay in a one-sided…
A Florida health system is putting social determinants of health (SDOH) right into the electronic health record problem list, where doctors can see and act on them. Spearheading this initiative is Jennifer Goldman, DO, chief of Memorial Primary Care at the six-hospital Memorial Healthcare System, based in Hollywood, Florida. In this interview with HealthLeaders, Goldman…
The Centers for Medicare & Medicaid Services (CMS) is moving forward with a major overhaul of the Medicare accountable care organization program to boost enrollment and address health equity gaps. As outlined in the final rule issued Tuesday, CMS will offer advance shared savings payments to low-revenue ACOs and allow longer periods of time for ACOs to…
Prioritizing the shift to value-based care has been at the forefront of the healthcare industry. But the road to transitioning from fee-for-service to value-based payment models is not always smooth. Convincing payers of value-based care’s feasibility is no longer the issue. The problem lies in the fact that basic healthcare operations do not support value-based…