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…
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…
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…
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…
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…