After an intense few years in health care, will 2023 deliver more punches? While 2022 was dubbed a COVID “recovery” year, as patient volume rebounded, health care staffing shortages festered. Burnout prompted physicians to retire, sell practices to corporate owners, or leave traditional health care for other employment. Simply put, 2022 was short on recovery…
The Center for Medicare & Medicaid Innovation (CMMI) has launched more than 50 alternative payment and care delivery model tests, with 33 models now or still operational, according to CMMI’s sixth report to Congress on its progress. These model tests have impacted the lives of millions of patients. In the two-year period covering the report,…
Download Slides CMS has released the Final Rule for 2023, and there’s plenty to unpack. Do you know how the new rules and updates will affect your organization? Is your ACO prepared for the end of the Web Interface and all-patient all-payer quality reporting? Is your organization using data effectively to overcome challenges and…
All stakeholders in the healthcare industry have gotten better at patient engagement in the past few years, as value-based care models have made it imperative that patients are involved in their own care management. But as more voices enter the conversation, it’s critical that there’s some coordination between both the payer and the provider, according…
The Medicare Merit-based Incentive Payment System (MIPS) unfairly penalizes physicians caring for a patient population with more complex medical needs, according to a study in JAMA Network. MIPS, the largest value-based payment system in the U.S., pays about 1 million physicians who care for Medicare patients based on scores in four categories: cost, quality, improvement…
Organizations’ net savings in the first year of a Medicare accountable care model varied widely, spotlighting the difficulties of delivering value-based care, where just a few sick patients or a substandard operational model can significantly skew results, experts say. Direct contracting entities in the Global and Professional Direct Contracting Model had a roughly 2% net…
Although reports of physician burnout multiplied during the COVID-19 pandemic, it has always been a problem in health care. According to a study from the Mayo Clinic, the COVID-19 pandemic only exacerbated existing problems in the health care delivery system and took a toll on the U.S. physician workforce. This added strain impacted the quality…
Nearly two dozen House and Senate Democrats are pressing the Biden administration to remove 10 organizations with documented fraud and waste from the controversial ACO REACH payment model that starts next year. The letter, released by a collection of 21 House and Senate lawmakers last week, is the latest scrutiny to befall the alternative payment…
More than 20 progressive lawmakers are raising concerns about ACO REACH in a new letter to the CMS, arguing the model gives insurers with a history of defrauding Medicare another toehold in the program and asking regulators to eject those entities from the alternative payment model. ACO REACH, slated to begin in January, is a redesign of…
The second evaluation report on Vermont’s All-Payer ACO Model (VTAPM) Agreement found that although the pandemic and a cyberattack on the University of Vermont Health System posed unique challenges in 2020, the Medicare ACO initiative continued to reduce spending and utilization in payment year 3 relative to a comparison group. The initiative also continued to…