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NAACOS, AMA Urge Congress to Boost Value-Based Care, APM Incentives

February 4, 2022Garrett SchmittAMA, APMs, congress, NAACOS

A group of eight healthcare organizations, including the American Medical Association (AMA) and National Association of ACOs (NAACOS), have asked Congress to increase their efforts in promoting value-based care and alternative payment model (APM) adoption. In a letter sent to the Senate Committee on Finance Subcommittee on Fiscal Responsibility and Economic Growth, the organizations highlighted…

Raising the Bar: Using Primary Care Practice Standards to Advance Health Equity in Medicaid

February 3, 2022Garrett Schmitthealth equity, PCP, Primary Care

States are increasingly focusing on health equity, and in particular racial health equity, as a key priority within their Medicaid programs ― often explicitly building health equity requirements into managed care contracts. Ensuring equitable access to high-quality and comprehensive primary care is central to achieving meaningful progress toward this goal. As a result of structural…

Prevention suffers when doctors drop out of Medicare’s ACO program

February 3, 2022Garrett SchmittACOs, Medicare, MSSP, physicians

For 10 years, the agency that runs Medicare has offered doctors and their practices extra money if they joined groups called Accountable Care Organizations and improved the quality of care they provided to older patients covered by traditional Medicare, while also focusing on the cost of their care. But a new study finds that those…

Why Rideshare in Healthcare Is Key to Value-Based Care Success

February 3, 2022Garrett Schmitt

Across the nation, fee-for-service is giving way to value-based care contracts. And as those scales tip, Buck Poropatich, the new head of healthcare for Lyft, thinks rideshare will be key to value-based care success. This comes after nearly two years of a global pandemic in which Lyft and other rideshare services demonstrated how well they…

Along with rate increase for MA plans, CMS pitches closer look at social determinants of health

February 3, 2022Garrett SchmittMedicare Advantage, SDOH

CMS is proposing a nearly 8% revenue increase for Medicare Advantage plans next year, according to a proposed payment plan released Wednesday. The overall rate increase for 2023 includes a 4.75% effective growth rate and a 3.5% average increase in risk scores. The risk-adjusted benchmark trend, which analysts peg as the key number, comes out…

RPM 101: What Is Remote Patient Monitoring, Its Benefits, and Uses?

February 2, 2022Garrett SchmittCOVID-19, pandemic, remote patient monitoring, RPM

Remote patient monitoring (RPM) though by no means a new care modality is evolving rapidly, spurred by the constraints of the COVID-19 pandemic and the corresponding regulatory push to expand access to care. In its simplest form, RPM involves the use of connected electronic tools to record personal health and medical data in one location…

Volume vs. value: Physician compensation models slow to adapt

February 2, 2022Garrett SchmittAPMs, FFS, Physician Compensation, value-based payment

Despite the promise of value-based care, the current compensation structure continues to incentivize physicians for volume. A payment hierarchy exists in the U.S. health care system. Reimbursement mechanisms used by payers create incentives for health systems and physician organizations. In turn, these organizations create incentives for physicians through compensation packages, which may or may not…

Court-Issued Fines And Fees Frequently Undermine Health Equity

February 2, 2022Garrett Schmitthealth equity

In March 2015, the Civil Rights Division of the US Department of Justice issued a scathing report on policing practices in Ferguson, Missouri, where Michael Brown, an 18-year-old Black man, had been shot and killed by police the year before. It described a police department that routinely issued citations to generate revenue for the city’s…

How do physicians get paid? (Hint: It’s mostly not value-based.)

February 1, 2022Garrett SchmittPhysician Compensation

Despite a significant push towards value-based care in recent years, many health systems still largely compensate physicians based on the volume of their services, according to a new study from RAND Corporation. A push for value-based care According to Fierce Healthcare, there has been an ongoing push across the health care industry, particularly from payers,…

Physician Compensation Still Hinges on Volume at System-Owned Practices

February 1, 2022Garrett SchmittAPMs, FFS, Physician Compensation, value-based payment

Despite a decades-long push toward value-based payment, physician compensation arrangements at health system-owned practices still primarily revolves around the volume of services delivered, according to a new study from RAND Corporation. The study recently published in JAMA Health Forum examined physician compensation structures at 31 physician organizations affiliated with 22 health systems in four states….

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