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…
For Morgan Honea, CEO of CORHIO (a Contexture organization), the value of interoperability between healthcare and dental settings revealed itself during his earlier career running federally qualified health centers (FQHCs). “I’ve spent most of my career integrating primary, oral, and behavioral healthcare in a service delivery setting,” Honea told EHRIntelligence in an interview. “There are so many medical…
Data standards and community stewardship are critical elements for social determinants of health (SDOH) data exchange, according to Greg Bloom, strategic advisor on community resources and engagement for the Gravity Project, a community-led HL7 Fast Healthcare Interoperability Resources (FHIR) Accelerator. The Gravity Project worked with healthcare stakeholders such as health IT vendors, payers, providers, philanthropies,…
Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage continues to demonstrate that it offers important cost protections and value for Medicare Advantage beneficiaries,” said Allison Rizer, principal at ATI Advisory…
Download Slides One of the biggest hurdles for value-based care is motivating patients to adopt healthier lifestyles and adhering to care plans – for the long term. Contrary to popular belief, it’s NOT enough to just inform and educate patients, especially those with chronic conditions. We already provide patients with plenty of well-designed handouts…