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Reducing Low-Value Care Key to Value-Based Reimbursement Success

February 1, 2018acoNo CommentsReimbursement

Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While hospitals and health systems have flocked to value-based care strategies, such as population health management programs and high-risk patient interventions, the non-profit academic healthcare organization in…

Patient Engagement Strategies Lack Patient Voice, Consumer Input

January 29, 2018acoNo CommentsPatient Engagement, Patient Satisfaction

Healthcare organizations are increasingly recognizing the imperative for patient-centered care in value-based payment models, but very few are adequately incorporating the patient voice into their strategies, according to a recent report from the Health Care Transformation Task Force (HCTTF). “The transition to value-based payment has generated more momentum for implementing high-quality, patient-centered care and involving…

8 Things to Know About Telehealth for 2018

January 24, 2018acoNo CommentsTelehealth, Telemedicine

In 2017 we saw an evolution in how employees are seeking care. Aligned with a recent National Business Group on Health study that indicates that 96% of large employers are now offering some level of telehealth benefits today, more and more employees were engaging with telehealth in 2017 and learning firsthand that they could receive…

17 ACOs join CMS’ Next Generation model

January 24, 2018acoNo CommentsCMS, Medicare, Next Generation

There are 58 ACOs in CMS’ Next Generation model for 2018, including 17 new participants, CMS data shows. Most ACOs participating in the Next Generation model are veterans of the Medicare Shared Savings Program and the Pioneer ACO Model. This year, five of the Next Generation ACOs are new to ACO programs, as pointed out…

What Are the Benefits of Accountable Care Organizations?

January 23, 2018acoNo Comments

Accountable care organizations (ACOs) are provider and payer arrangements established to improve care coordination between primary care physicians, hospitals, specialists, and public or private health payers. The Centers for Medicare & Medicaid Services (CMS), for instance, has created the Medicare Shared Savings Program in which accountable care organizations must meet quality performance benchmarks and reduce Medicare…

AMGA: Align Quality, Performance across Medicare Advantage, ACOs

January 18, 2018acoNo CommentsAMGA, CMS, Medicare, Medicare Advantage

CMS should work to align quality and performance standards across all Medicare programs, including Medicare Advantage (MA) and the Medicare accountable care organization (ACO) initiatives, says AMGA. In a letter issued in response to proposed changes to MA and Medicare Part D, AMGA President and CEO Jerry Penso, MD, MBA, argued that more standardization across…

Study: Maryland’s value-based care program controlled costs but didn’t necessarily improve care

January 17, 2018acoNo Comments

A new study finds mixed results for an innovative program in Maryland to cut healthcare spending while improving outcomes. Four years ago, the state instituted a new payment system that gives the majority of acute care hospitals an annual all-payer global budget for inpatient, emergency department and outpatient department services. The program aimed to control…

In Illinois, an MSSP ACO Proves its Worth Once Again

January 16, 2018acoNo CommentsACO, CMS, Medicare, Medicare Shared Savings Program, MSSP

In late October, the Centers for Medicare & Medicaid Services (CMS) announced that Downers Grove, Ill.-based Advocate Health Care, the largest health system in the state, and its affiliated Medicare accountable care organization (ACO), Advocate Physician Partners Accountable Care, Inc., realized $60.6 million worth of cost savings in 2016. Ranking second in savings of 432…

Value-based care will reinvigorate EHRs, boost AI, advance home telehealth

January 11, 2018acoNo CommentsAI, EHR, Telehealth, Telemedicine

The state of value-based reimbursement efforts has been uncertain. Many healthcare organizations are indeed pursuing newer strategies to replace traditional fee-for-service care while reducing costs and improving quality, but progress has often been halting. Still, experts from Cedars-Sinai, CVS Health, Blue Cross NC and Harvard Pilgrim Health Care say they’re quite optimistic for the future…

MedPAC Backs Bid to Scrap MIPS Medicare Pay System Amid Dissent

January 11, 2018acoNo CommentsMedicare, MedPAC, MIPS, Physician Compensation

WASHINGTON — Members of an influential federal advisory panel sparred here today over a recommendation that would direct Medicare to scrap its fledgling Merit-based Incentive Payment System (MIPS) and instead implement a new approach for tying reimbursement to judgements about value of care. The Medicare Payment Advisory Commission (MedPAC) voted 14 to 2 in favor…