To advance its goal of having 100% of people in traditional Medicare in an accountable care relationship in seven years, the Centers for Medicare and Medicaid Services has announced three initiatives in the Medicare Shared Savings Program and the ACO REACH and Kidney Care Choices models. More than 700,000 healthcare providers and organizations will participate…
The new value-based care model ACO REACH has been touted as the first ever to hold providers accountable for tackling health equity. But some providers say the Biden administration isn’t offering enough financial incentives for them to fully reach patients in extremely underserved communities. This year is the first performance period for the ACO REACH…
A recent study out of the Weill Cornell Medical College questions whether the Merit-Based Incentive Payment System (MIPS) accurately captures the quality of care delivered by primary care physicians. Published in JAMA in December, the cross-sectional observational study of over 80,200 primary care physicians found that MIPS scores were inconsistently related to performance on both…
UnitedHealth Group is planning to integrate more behavioral and home health services into its care delivery strategy as the company continues to expand its value-based care offerings. “We will serve these patients in clinic settings, in their homes, integrating behavioral care, supported by our data-driven clinical incidents and next best actions, and all coordinated to…
Download Slides I Is your ACO prepared for a new challenge in 2023? If preparing for APP (Alternate Payment Model Performance Pathway) reporting wasn’t in your New Year’s resolutions, attend this webinar! Now that CMS has foreclosed the option of continuing to report through the CMS Web Interface in two years, you can’t afford to lose the…
Lumeris empowers health systems to deliver exceptional value-based care through technology, insurance capabilities and on-the-ground know-how. Using their highly-acclaimed model and a team that is both passionate and experienced, Lumeris helps their partners advance population health, improve provider and patient experiences, enhance financial stability, achieve market-leading results, and ultimately fulfill the promise of value-based care….
Efforts to make the healthcare system more efficient and equitable by adjusting population-based payments for social risk factors may be missing the mark, suggests a new study from Harvard and Yale. The study published in the latest edition of Health Affairsputs current risk adjustment methodologies under a microscope to find out if they truly support…
As the industry moves deeper into value-based payment models and takes accountability for the health of populations, primary care is serving as one of the highest priorities for health systems and networks alike. We are at a critical juncture where independent, affiliated and employed physicians, as well as the employers and health systems working with…
CareJourney is a leading source of provider cost and quality analytics for the healthcare industry. They support payers, value-based networks and numerous ACOs, helping them assess value-based care models, optimize provider performance, coordinate patient care and uncover market growth opportunities. CareJourney does this by consolidating and enriching Medicare FFS, Medicare Advantage and Medicare and Commercial claims…
Participating in Medicare’s Bundled Payments for Care Improvement (BPCI) initiative was associated with cost savings for medical and surgical episodes, but savings varied among hospitals and physician groups, according to a study published in JAMA Health Forum. Full Article