New bipartisan legislation introduced in the House aims to reform Medicaid to enable the use of value-based purchasing agreements in Medicaid. The Medicaid VBP Act, released Tuesday, aims to ensure new treatments such as gene therapies would be administered under Medicaid via a value-based agreement that reimburses drug makers based on the outcomes the drug provides….
Starting in January 2023, health care payment policy will take an important step toward health equity. Last month, the Centers for Medicare and Medicaid Services (CMS) announced a new accountable care model that replaces the prior Directing Contracting models and incorporates changes to help organizations address equity and access through accountable care organization (ACO) participation….
Health systems, hospitals, and community health clinics have a substantial part to play in patients’ lives. As trusted sources of healthcare and information, US providers may help patients understand the links between unmet basic needs—or social determinants of health (SDOH)—and health while supporting patients in meeting these needs (see sidebar, “Unmet basic needs and other…
The American Hospital Association (AHA) has launched its Health Equity Roadmap, a resource to support hospitals and health systems. The road map consists of three parts: an equity transformation assessment, a customized action plan and a virtual community of peers. The resource is meant to meet providers where they are in their equity journey, the…
Hospice providers are seeking greater clarity when it comes to quality incentives in the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) program. Introduced in late February, ACO REACH replaces the Global and Professional Direct Contracting (GPDC) models. CMS indicated that the program reflects its refreshed priorities for payment system demonstrations. Among…
Download Slides Find out what ACOS need to know about the latest CMS requirements. Learn about SDoH information capture and how equity will impact ACOS, providers and members. Plan for the future! Understand the new CMS requirements and what you need to do. Visit the mPulse Mobile Exhibit Booth
Appropriate Care: What’s the big deal? It is well known that the United States spends more than any other nation on healthcare, but as a nation, our health outcomes miss the mark. As evidence-based medicine evolves, it is important that our healthcare practices adapt. With burnout at an all-time high and staff shortages on the…
Accountable care organizations (ACOs) participating in the Medicare program have had their share of challenges making their finances work, and nowhere is that more true than for rural ACOs. “Rural ACOs have found out that there are some big adjustments that need to be made to the risk adjuster,” including in Medicare’s new ACO Realizing…
The Diabetes Eye Exam quality measure is commonly referred to as one of the most difficult care gaps to close. Since up to 50% of diabetic patients lack documentation of a retinal eye exam, ACOs and practices spend a significant amount of administrative time each year chasing charts to close this measure. At Topcon,…
Download Slides Value-based payment programs can achieve the aim of accountable care, which is to drive quality, improve care coordination and reduce care cost. So what does a successful VBP program look like in real life? In this session, we will discuss ways to design and implement an effective VBP program for Skilled Nursing…