In any given community, the local health system is probably one of the biggest employers. It’s probably also one of the biggest spenders and biggest concentrations of social capital. The word for that is anchor institution, and healthcare organizations need to embrace that status in order to keep the health equity ship moving. For nearly…
Providers and payers are increasingly addressing the health-related social needs (HRSNs) of their patients to improve outcomes, reduce costs, and address health disparities. As this practice takes hold in the field, the landmark Accountable Health Communities (AHC) Model test that launched in 2017 has now ended. AHC was the Centers for Medicare and Medicaid Services’…
A new report, funded by the Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation and the Office of the National Coordinator for Health IT, summarizes interviews with executives at 21 organizations involved in value-based care. The report focuses on the barriers to and facilitators of data integration in support of value-based…
ACOs with independent participants have struggled with their highest performing practices being recruited by multi-ACO enabler entities. From the other perspective, provider practices are challenged with selecting from an increasing array of enabler contracts as alternatives to CMS’s BASIC, ENHANCED and REACH models. When making PY 2023 track decisions, affected ACOs and practices benefit from…
Health equity in America is a vast topic, and I’m sure there are people much more expert in this area than I am. However, as a Black man, and as the CEO of a healthcare technology company that works with thousands of clinical organizations, I believe it’s my obligation to learn, speak out, and take…
The nonprofit National Committee for Quality Assurance has revised quality measures for health plans in the Healthcare Effectiveness Data and Information Set (HEDIS) for measurement year 2023. NCQA has added race/ethnicity stratifications and made revisions to acknowledge and affirm member gender identity. Collecting race and ethnicity data is key to improving health disparities, NCQA said….
CMS’ announcement of the redesigned Global and Professional Direct Contracting (GPDC) program, now ACO REACH, created an opportunity for REACH participants to focus on health equity and to finally receive reimbursement payments that are adjusted to their patients’ specific needs. This post is the second part of a two-part series. Now that we understand how…
Value-based care (VBC) is quickly becoming the future of healthcare. By 2030, CMS expects 100% of traditional Medicare beneficiaries to be treated by a provider in a value-based care model. The objective is to improve the quality of patient care based on specific measures, such as lowering the overall cost of care, reducing hospital readmissions,…
Download Slides August 1 marks the beginning of the CMS ACO REACH model implementation period, gearing up for the first performance year beginning January 1, 2023. Whether your organization is participating or not, the drive to incorporate SDOH to improve quality of care and outcomes is an initiative that will make its way to…
There is substantial variation and low correlation in healthcare spending across Medicare, Medicaid, and private insurance plans within different US regions, a study published in JAMA Network Open found. The US spends around $3.8 trillion per year on healthcare funded by Medicare, Medicaid, and private insurers. However, spending and healthcare utilization are rarely the same…