Championed by government entities like the Centers for Medicare and Medicaid Services and the Department of Health & Human Services, value-based care is here to stay. Hospitals are increasingly participating in value-based programs—such as the Hospital Readmissions Reduction Program and Bundled Payments for Care Improvement—in an effort to improve care delivery and patient outcomes while…
What level of integration makes for a successful post-acute care network? Antonio Rodriguez, M.D., medical director of the continuing care network for UNC Health Alliance in North Carolina, recently described a decision-making framework for healthcare systems that are taking their first steps in building post-acute care networks. Rodriguez, a family medicine physician, was speaking at…
As the medical industry continues to understand how social determinants of health impact overall wellness, the topics of environment and climate change have come into view. SDOH specifically refer to the environments in which individuals live, work, and play. Currently, most stakeholders are zooming in on factors like houselessness or food insecurity as leading SDOH…
In the opening session of this year’s National Association of Accountable Care Organizations (NAACOS) Spring Conference, NAACOS president and CEO Clif Gaus, ScD, moderated a discussion with Rob Fields, MD, MHA, chief population health officer at Mount Sinai Health System, and Meena Seshamani, MD, PhD, deputy administrator and director, Center for Medicare,, CMS. Throughout the session,…
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. These value-based…
The Biden administration wants to change how benchmark payments to accountable care organizations are calculated to make it easier for providers in the Medicare Shared Savings Program (MSSP) to qualify for savings. Leaders in the Centers for Medicare & Medicaid Services (CMS) outlined several changes they are pursuing to get more providers involved in value-based…
Nathan Moore, M.D., medical director of the BJC Medical Group ACO in St. Louis, sees annual wellness visits (AWVs) as a scaffolding for all of the ACO’s improvement efforts. “We’re using this as our point of entry for advanced care planning and for functional status evaluations,” he said. Moore was speaking during an April 28…
This week, a group of senior officials from the Centers for Medicare and Medicaid Services (CMS), some from the Center for Medicare, some from the Center for Medicare & Medicaid Innovation (CMMI, also called The Innovation Center) authored an op-ed in the Perspectives section of The New England Journal of Medicine online, in which they outline their…
Nathan Moore, M.D., medical director of the BJC Medical Group ACO in St. Louis, sees annual wellness visits (AWVs) as a scaffolding for all of the ACO’s improvement efforts. “We’re using this as our point of entry for advanced care planning and for functional status evaluations,” he said. Moore was speaking during an April 28…
Value-based payment models that shared five-year expected savings offered stronger incentives for clinicians to implement preventive interventions for postpartum depression compared to models that offered shared savings over just one year, according to a study published in JAMA Network Open. The Affordable Care Act requires most commercial health insurance plans to cover preventive services for pregnant or postpartum…