In 2019, 48 percent of Medicare-Medicaid dual-eligible beneficiaries identified as being from a racially/ethnically minoritized group, while only 21.6 percent of Medicare-only beneficiaries were from racially/ethnically minoritized groups. Since 2006 the percent of dual-eligible beneficiaries from racially/ethnically minoritized groups has grown by 19.2 percent, and we can expect this growth to continue as our population…

Medicare’s Shared Savings Program (MSSP) saved CMS $1.66 billion in 2021, marking the fifth consecutive year of overall savings for the program; however, savings from performance year 2021 represent a decline from 2020, when ACOs saved Medicare $1.9 billion. The 475 participating ACOs compromising half a million clinicians provided service to 11,000,000 Medicare patients, with…

Are accountable care organizations (ACOs) potentially creating financial savings by neglecting or limiting care for serious mental illness (SMI)? A team of researchers has examined the issue for an article in Health Affairs. Based on their analysis, it appears that such is not the case; but there is complexity, which the researchers explore in their…

Closed loop communication is a defined strategy that’s frequently used in complex environments, such as acute care settings, to reliably exchange critical information quickly and concisely. With this technique, an individual shares information with another person and the receiver repeats the information back and asks any follow-up questions to gain clarity. The person initiating the…

“We shall have no better conditions in the future if we are satisfied with all those which we have at present. ― Thomas A. Edison  Value-based care (VBC) and population health management (PHM) will be impacted for years to come as a result of the COVID-19 pandemic. There is little doubt that COVID-19 brought about…

Ahead of the September 6 comment deadline, the American Medical Association and 10 other provider organizations submitted comments to the Centers for Medicare and Medicaid Services on how the 2023 Medicare Physician Fee Schedule Proposed Rule affects accountable care organization models. The rule, if finalized, would bring several positive changes to the Medicare Shared Savings Program,…

At this week’s National Human Genome Research Institute meeting on “genomic learning healthcare systems,” an Intermountain Healthcare executive described the link between value-based care and precision medicine. Howard McLeod, PharmD, executive clinical director of precision health for Utah-based Intermountain Healthcare, initially spoke about the learning health system approach at Intermountain. McLeod said that for a…

For several years now, the healthcare industry has been slowly but surely inching toward the tipping point of value-based care. While the Health Care Payment Learning & Action Network (HCPLAN) states that just 39.3% of all payments had no link to quality or performance in 2020, the organization also found that only 17.9% of reimbursements flowed through…