Value-based behavioral health involves measuring an organization’s impact on a patient’s health. How impact is defined and translated into value varies depending on several factors. At the broadest level, the various levels of care acuity require different approaches. They may also have advantages and disadvantages when it comes to value-based care in the first place….
The release on July 10 of the proposed Calendar Year 2025 Medicare Physician Fee Schedule from the Centers for Medicare & Medicaid Services (CMS) prompted discussions among healthcare industry professionals. On July 16, the Washington, D.C.-based Primary Care Collaborative (PCC) hosted an online discussion with CMS leaders about how Medicare Part B payment policy could…
In the U.S. health system, various determinants and factors such as income, race, education, gender, sexuality, and even zip code significantly influence our health outcomes. These factors affect how healthy we are, the frequency and severity of illnesses, our access to care, and even our life expectancy. Consider these stats: Non-Hispanic Blacks/African Americans have 2.4…
Accountable care organizations (ACOs) face unique burdens to comply with CMS’s new quality reporting requirements as summarized in this 2021 MedCity News article. Challenges are particularly acute for ACOs that delayed conversion from CMS’s Web Interface to the new electronic clinical quality measures (eCQM) quality reporting. Many ACOs have made the change. But many have…
Meticulous documentation is the name of the game for nursing home operators looking to keep up with Minimum Data Set (MDS) changes and maintaining a good rating in the Five-Star Quality Rating System. This is especially because inaccurate or insufficient data could affect a facility for at least a year in the future. Leaders in…
Momentum for value-based care grows as physicians gain more experience with value-based models and commit to improving outcomes – rewarding patients and providers alike. Investing in value-based care allows physicians to spend more time with their patients and, in doing so, deliver high-quality care that takes patients’ needs and preferences into consideration. Patients, providers and…
Accountable care organizations (ACOs) need better communication to explain how they are helping Medicare patients achieve better health at a better overall cost. The National Association of Accountable Care Organizations (NAACOS) and the Health Care Transformation Task Force published “Reimagining Beneficiary Engagement in Accountable Care Models.” The white paper outlines how ACOs, the longest-standing alternative…
In the rapidly evolving landscape of healthcare, staying ahead of regulatory changes and quality reporting requirements is crucial for both Accountable Care Organizations (ACOs) and clinicians participating in the Quality Payment Program (QPP). The Centers for Medicare & Medicaid Services (CMS) has introduced significant proposals that impact the Medicare Shared Savings Program (MSSP) and the…
The Commonwealth Fund has published the results of a study seeking to understand why more primary care practitioners (PCPs) are not participating in value-based payment (VBP) models. After conducting focus groups with PCPs who have not participated in VBP models and interviews with primary care executives and association leaders, the report offers some recommendations about…
As we move through the second half of 2024, managed care organizations must prioritize member engagement, especially for individuals with chronic conditions. This period presents an opportunity to embrace strategies that encourage essential healthcare visits, such as annual wellness and primary care appointments. Read on for member engagement tactics that focus on precise member identification,…