Medicare population-based payment models, broadly known as accountable care organization (ACO) models, of which the Global and Professional Direct Contracting Model (GPDC) is an example, were launched out of recognition of two largely inherent weaknesses of fee-for-service: FFS does not promote efficiency, nor does it promote equity. The Centers for Medicare and Medicaid Services (CMS)…
The question of whether ACOs should be forced to accept “downside risk” — in effect pay a penalty if they exceed certain spending benchmarks — has bedeviled CMS’ ACO programs and ACO programs in general. Seema Verma, the Trump administration’s CMS director, pushed for more downside risk, and the administration’s Pathway to Success program shortened…
Your health care organization may be on the tightrope of still coping with COVID-related illness and delivering essential patient care, amidst staffing and supply shortages. But in 2022, life is not poised to give health care a breather. Likewise, there is no slow-down to the expansion of Value-Based Care and payment models or development of…
In the event of a healthcare ransomware attack, organizations must make the difficult decision between giving in to ransom demands or potentially risking patient safety. As healthcare ransomware attacks continue to ramp up across the sector, many organizations will be forced to make a difficult decision: give in to ransom demands or potentially risk patient safety and…
The COVID-19 pandemic has brought social and racial inequity to the forefront of public health. In the United States, the pandemic has affected many communities, including racial and ethnic minorities as well as low-income populations, more severely than other groups. Negative health outcomes are more common among individuals within these groups, and social determinants of…
Researchers called for the creation of a medical device data standards development organization to support healthcare interoperability. The healthcare industry needs better data standards to support medical device interoperability, according to an article published in JAMA Health Forum. The authors noted that much of the existing infrastructure for healthcare interoperability has focused on EHRs. ONC mandated the adoption…
Digital health continues to break funding records as companies across the globe raked in $30.7 billion in venture capital in 2021, according to data from Digital Health Business & Technology. Investments during the fourth quarter were $7.6 billion across 206 deals, a 6% drop from the recording-setting $8.1 billion raised by digital health companies during…
In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. CMMI considers APMs to be any arrangements whereby providers are held accountable for the quality and costs of care,…
The Pharmacy Quality Alliance (PQA) has issued a new resource guide to help pharmacists navigate certain social determinants of health that might crop up when a patient visits the pharmacy. Particularly, the resource guide details 20 real-world programs that help address social determinants of health that affect patients’ abilities to access or manage their medications….
The usage of multiple electronic health record (EHR) systems is a common occurrence among accountable care organizations (ACOs). This paper summarizes the results of a survey on EHR usage within ACOs and discusses some of the issues this may present in reporting quality measures, including that: Just 9% of surveyed ACOs use a single EHR…