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Progressive lawmakers call on CMS to cull companies with history of Medicare fraud from ACO REACH

December 12, 2022Garrett Schmitt

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…

Vermont All-Payer ACO Makes Progress on Cost, Quality Goals

December 9, 2022Garrett Schmitt

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…

AHCA CEO: Value-Based Care ‘Most Exciting’ Development of His 30-Year Skilled Nursing Career

December 9, 2022Garrett SchmittACOs, CMS, nursing homes, SNFs

Skilled nursing providers are facing an extremely challenging operating environment, but they must keep adapting and innovating as the shift toward value-based care continues across the U.S. health care system. And in fact, providers have tremendous opportunities to seize. “Value-based care through the population health management model is the most exciting thing I’ve had the…

10 payer value-based care partnerships to know

December 9, 2022Garrett Schmitt

Payers are investing in value-based care, teaming up with Walmart and many other companies to prioritize quality-based payments. Around 4 in 10 health plans use alternative payment models, a survey from the Healthcare Payment Learning and Action Network found, with these models most common among Medicare Advantage plans. Here are 10 partnerships Becker’s reported this…

How AI and machine learning can predict illness and boost health equity

December 8, 2022Garrett Schmitt

Artificial intelligence and machine learning are key to unlocking patient data and solving some of healthcare’s most complex problems. Even as the U.S. seeks to put the COVID-19 pandemic in the rearview mirror, many who survive the initial illness suffer debilitating long-term health impacts, especially those with underlying health conditions. Technology allows easier access to…

Health Equity Experts and Top Policy Leaders Launch Midwest Health Equity Coalition to Identify Evidence-Based Best Practices for Reducing Racial Health Disparities in America

December 7, 2022Garrett Schmitt

A diverse group of mission-aligned health systems, a Medicare Advantage health plan, a healthcare analytics solutions company, the association representing Illinois community health centers, health policy leaders, and other health partners came together today to launch the Midwest Health Equity Coalition. The coalition will serve as a brain trust of experts committed to reducing racial…

The road to Oz: 5 ways physicians can finally reach the promised land of value-based care

December 6, 2022Garrett Schmitt

For years we’ve been promised the Emerald City of the U.S. healthcare – a value-based care model. And for good reason. The volume-based fee-for-service care approach we have now is the most expensive in the world and among the worst in quality. We spend 20% of the country’s GDP on healthcare at an average cost…

The Role of ACOs in Advancing Health Equity: A Comparison Between MSSP and ACO REACH

December 6, 2022Garrett Schmitt

CMS’s recent integration of health equity into its new and existing value-based payment (VBP) programs (as outlined below) signals a strong commitment to equitable care delivery. We expect health equity to be incorporated into additional federal programs and for private payers to follow CMS’s example in designing their own plans for managing the diverse needs…

Value-Based Payment Models May Help Curb High Healthcare Spending

December 5, 2022Garrett Schmitt

As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs research brief. During 2020, the first year of the COVID-19 pandemic, healthcare spending accounted for 19.7 percent of US gross domestic product…

Is Digital Health Closing Gaps in Health Equity?

December 5, 2022Garrett Schmitt

Type 2 diabetes (T2D) disproportionately affects racial and ethnic minority groups. Black Americans are 50% more likely to have T2D, and are at higher risk for complications, than whites.1 They are also the group with the highest rates of obesity. 40% of Latinos with T2D have not been formally diagnosed, and 45% struggle with obesity….

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