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For Health Care Providers, Five Trends To Watch In 2022

January 31, 2022Garrett SchmittCOVID-19, pandemic, providers

Today’s environment is one of two narratives: On one hand, there’s optimism as more Americans receive vaccines and resume in-person interactions. On the other hand, people are frustrated as the pandemic drags on with new variants and mixed guidance, and the return to normal is stymied by price inflation and supply chain disruptions. For health…

Implementing value-based care to drive success for life sciences companies

January 31, 2022Garrett SchmittLife Sciences, Risk, value-based care, vbc

In an attempt to curb rising costs, the U.S. medical system is moving away from traditional fee-for-service healthcare. Traditional fee-for-service and volume-based healthcare models pay providers for the amount of healthcare services they provide, not the quality of that care. Value-based care is the new model: a system in which providers are paid for performance and patient…

Mass General Sets Sights on Maternal Health Equity with New Partnership

January 28, 2022Garrett Schmitt

A new partnership with Mass General Brigham and The New Commonwealth Racial Equity and Social Justice Fund (NCF) will invest $2.5 million to improve maternal health equity, support a diverse maternity practitioner workforce, and boost patient care and clinical outcomes. Particularly, the funding will help Mass General and The NCF build a cohort of Black…

Most health systems still base doctors’ pay on volume, despite push toward value-based care: study

January 28, 2022Garrett Schmittalternative payment models, APMs, fee-for-service, FFS, value-based care, value-based payment, vbc

Despite the growth in value-based payment arrangements from payers, health systems continue to pay physicians based on the volume of services they provide. A new study published in the journal JAMA Health Forum finds that volume-based compensation was the most common type of base pay for more than 80% of primary care physicians and for more…

ACO Investment Model Produced Savings, But The Majority Of Participants Exited When Faced With Downside Risk

January 27, 2022Garrett SchmittACO, ACOs

Medicare’s Accountable Care Organization (ACO) Investment Model (AIM) provided up-front funding to forty-one small, rurally located ACOs to encourage their participation in the Medicare Shared Savings Program. We estimate net savings to Medicare of $381.5 million over three years, driven by utilization reductions in inpatient and other institutional care and by the absence of shared…

More Beneficiaries, But Fewer ACOs for Medicare Shared Savings Program

January 27, 2022Garrett SchmittACOs, Medicare, MSSP

Accountable care organizations (ACOs) in the Medicare Shared Savings Program will care for more beneficiaries in 2022, making it the largest alternative payment model in Medicare despite lackluster ACO participation numbers this year, according to new program data from CMS. Over 11 million Medicare beneficiaries will be attributed to a provider practicing as part of…

Chernew, MedPAC’s Chair, Comes Out Against Berwick’s Assertions, in Health Affairs

January 27, 2022Garrett Schmitt

In yet another sign that the huge debate stirred up by Donald M. Berwick, M.D., and Richard Gilfillan, M.D., by their publication on Sep. 30, 2021 of their blog in Health Affairs online, “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2: Building On The ACO Model,” is far from being quieted, yet…

How to Use Longitudinal Patient Data to Create a Better Continuum of Care

January 26, 2022Garrett Schmitthealth data, healthcare data, patient data

In an effort to provide better healthcare at lower costs, an increasing number of payers are focusing on providing a “continuum of care.” This model strives to identify and deliver the most appropriate care for an individual based on factors such as age, lifestyle decisions, genetic predispositions, prior care received, and more. The ultimate goal…

Medicare Shared Savings ACO participation grows slightly for 2022

January 26, 2022Garrett Schmittaccountable care, ACOs, Medicare, Medicare Shared Savings Program, MSSP

More Medicare beneficiaries will receive care from providers in Medicare Shared Savings Program accountable care organizations this year, but the number is still lower than it was in 2020, new data show. Nearly 1 in 5 Medicare enrollees will be treated by Shared Savings Program ACO providers this year, a slight increase from 2021 but lower…

Examining the value-based care approach: How improved data models and analysis can remedy inequities

January 25, 2022Garrett Schmitthealth equity, value-based care, vbc

Over the past decade healthcare providers have increasingly adopted value-based care (VBC) approaches, a move fueled greatly by the 2010 passage of the Affordable Care Act (ACA), as well as the recognition of the exorbitant costs of medical care, and the racial and socioeconomic inequities in healthcare access. VBC is tied to various alternative payment…

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