In previous blogs, we have discussed programs whose goals are to improve patient outcomes through quality care while increasing provider efficiency. An additional program provided by CMS to help in these efforts is the Chronic Care Management (CCM) program. CMS has made CCM available to Medicaid ACOs as they seek to create savings for both…
Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While hospitals and health systems have flocked to value-based care strategies, such as population health management programs and high-risk patient interventions, the non-profit academic healthcare organization in…
Healthcare organizations are increasingly recognizing the imperative for patient-centered care in value-based payment models, but very few are adequately incorporating the patient voice into their strategies, according to a recent report from the Health Care Transformation Task Force (HCTTF). “The transition to value-based payment has generated more momentum for implementing high-quality, patient-centered care and involving…
In 2017 we saw an evolution in how employees are seeking care. Aligned with a recent National Business Group on Health study that indicates that 96% of large employers are now offering some level of telehealth benefits today, more and more employees were engaging with telehealth in 2017 and learning firsthand that they could receive…
There are 58 ACOs in CMS’ Next Generation model for 2018, including 17 new participants, CMS data shows. Most ACOs participating in the Next Generation model are veterans of the Medicare Shared Savings Program and the Pioneer ACO Model. This year, five of the Next Generation ACOs are new to ACO programs, as pointed out…
Accountable care organizations (ACOs) are provider and payer arrangements established to improve care coordination between primary care physicians, hospitals, specialists, and public or private health payers. The Centers for Medicare & Medicaid Services (CMS), for instance, has created the Medicare Shared Savings Program in which accountable care organizations must meet quality performance benchmarks and reduce Medicare…
CMS should work to align quality and performance standards across all Medicare programs, including Medicare Advantage (MA) and the Medicare accountable care organization (ACO) initiatives, says AMGA. In a letter issued in response to proposed changes to MA and Medicare Part D, AMGA President and CEO Jerry Penso, MD, MBA, argued that more standardization across…
A new study finds mixed results for an innovative program in Maryland to cut healthcare spending while improving outcomes. Four years ago, the state instituted a new payment system that gives the majority of acute care hospitals an annual all-payer global budget for inpatient, emergency department and outpatient department services. The program aimed to control…
In late October, the Centers for Medicare & Medicaid Services (CMS) announced that Downers Grove, Ill.-based Advocate Health Care, the largest health system in the state, and its affiliated Medicare accountable care organization (ACO), Advocate Physician Partners Accountable Care, Inc., realized $60.6 million worth of cost savings in 2016. Ranking second in savings of 432…
The state of value-based reimbursement efforts has been uncertain. Many healthcare organizations are indeed pursuing newer strategies to replace traditional fee-for-service care while reducing costs and improving quality, but progress has often been halting. Still, experts from Cedars-Sinai, CVS Health, Blue Cross NC and Harvard Pilgrim Health Care say they’re quite optimistic for the future…