The Centers for Medicare & Medicaid Services (CMS) released its first ever home- and community-based services (HCBS) quality measures Thursday. The agency said the measures will promote “consistent quality measurement within and across state Medicaid HCBS programs” and are a “critical step to promoting health equity among the millions of older adults and people with…
While the Centers for Medicare & Medicaid Services (CMS) proposes to make some of the most significant changes to its accountable care organization (ACO) model since it was finalized in 2011, it doesn’t appear that such updates will have a lasting impact on the broader skilled nursing industry. If anything, only operators with their own…
Alternative payment models that put financial risk on healthcare providers improved care quality for patients with diabetes more so than fee-for-service and incentive payment programs, according to a new study published in Health Affairs. “Models that place greater financial risk on providers, such as global payment and shared savings, tend to demonstrate greater improvements in…
Over the past few years, we have seen an increase in tech-based approaches to improving maternal outcomes and the birthing journey. While most women still have in-person visits to check the progress of their pregnancy, deliver or check-in following delivery, technology can expand the reach of health care services. Digital solutions, including remote patient monitoring,…
The American Medical Association has criticized the new Medicare payment schedule proposed rule released last week by the Centers for Medicare and Medicaid Services, saying it fails to account for inflation in practice costs and “COVID-19-related challenges to practice sustainability.” The proposed 2023 Physician Fee Schedule (PFS) conversion factor is $33.08, a decrease of $1.53…
How you ramp-up to full-scale APMs is crucial. Even if your multi-specialty group or health system receives some value-based payments with downside risk, your success hinges both on financial viability and retention of your clinicians and patients. If you delay APM adoption only after reviewing the potential on your bottom line, you’ll need to pay…
CMS just set off summer fireworks, amping up incentives to adopt Value-Based Care in its just-released, 2,066-page 2023 Proposed Physician Fee Schedule Rule. By encouraging formation of new ACOs, the Proposed Rule establishes a pathway to expand beneficiaries’ access to accountable care. Last year, CMS committed that every Medicare beneficiary will be in an accountable…
Kenneth L. Davis, MD, believes that keeping patients healthy and ultimately out of the hospital is the key to making healthcare more affordable. That is why he is leading one of the nation’s top health systems down the path of value-based care adoption. Mount Sinai Health System has been at the forefront of the transition…
PART 1: Understanding the programmatic health equity components As the CMMI (Center for Medicare & Medicaid Innovation) Direct Contracting Program transitions to the ACO REACH Model in PY2023, many in the market have asked: “what has changed?” One notable change is the inclusion of one of the core tenants of the CMMI Strategic Plan announced…
The CMS is proposing an overhaul of the Medicare accountable care organization program in an effort to improve equity. The plan, which includes efforts to get more providers into ACOs and particularly ramp up rural participation, was applauded by ACO groups. The changes for ACOs in the Medicare Shared Savings Program would give some organizations more…