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Experts Discuss Driving Health Equity, Increasing CMS, ACO Alignment

April 29, 2022Garrett SchmittNAACOS

In the opening session of this year’s National Association of Accountable Care Organizations (NAACOS) Spring Conference, NAACOS president and CEO Clif Gaus, ScD, moderated a discussion with Rob Fields, MD, MHA, chief population health officer at Mount Sinai Health System, and Meena Seshamani, MD, PhD, deputy administrator and director, Center for Medicare,, CMS. Throughout the session,…

Breaking Down Common CMS Value-Based Payment Programs

April 29, 2022Garrett SchmittAPMs, FFS, MACRA, MIPS, SNF, value-based payment

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…

CMS targets reforms to benchmarks to kick-start flat ACO participation

April 28, 2022Garrett SchmittACO, ACOs, MSSP

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…

ACOs Using Wellness Visits as Scaffolding for Improvement Efforts

April 28, 2022Garrett SchmittCoronavirus, COVID-19, NAACOS, pandemic, value-based contracting

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…

CMS Officials Announce Major New Strategies Around ACOs

April 28, 2022Garrett SchmittCoronavirus, COVID-19, pandemic, SDOH, social determinants of health, value-based contracting

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…

ACOs Using Wellness Visits as Scaffolding for Improvement Efforts

April 28, 2022Garrett SchmittCoronavirus, COVID-19, NAACOS, pandemic, value-based contracting

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…

Shared Savings in Value-Based Payment Models Produce More Incentives

April 28, 2022Garrett SchmittAPMs, FFS, Physician Compensation, value-based payment

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…

Could Dentist Participation in HIE Unlock Patient-Centered Care?

April 28, 2022Garrett SchmittFHIR, Interoperability, Interoperability and Patient Access Rule, SDOH, social determinants of health

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, Community Stewardship Key for SDOH Data Exchange

April 21, 2022Garrett SchmittFHIR, Interoperability, Interoperability and Patient Access Rule, SDOH, social determinants of health

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,…

Key Advantages of Medicare Advantage Plans Versus FFS Medicare

April 20, 2022Garrett SchmittNo CommentsBMA, fee-for-service, FFS, Medicare, Medicare Advantage

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…

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