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…
WASHINGTON — Members of an influential federal advisory panel sparred here today over a recommendation that would direct Medicare to scrap its fledgling Merit-based Incentive Payment System (MIPS) and instead implement a new approach for tying reimbursement to judgements about value of care. The Medicare Payment Advisory Commission (MedPAC) voted 14 to 2 in favor…
A Health Affairs blog article co-authored this past year by 10 prominent health system CEOs describes the problem of physician burnout as a national public health crisis and “a matter of absolute urgency.” The numbers support their contention. The Medscape Lifestyle Survey 2017 reveals that 51 percent of physicians report experiencing this energy-depleting affliction, characterized…
Massachusetts has launched a new accountable care certification program designed to implement statewide, all-payer standards as part of care delivery. The program, the first of its kind in the country, is already off to a strong start, according to the Massachusetts Health Policy Commission (HPC), which announced it has certified 17 organizations, including hospitals, health systems and physician groups….
Effective population health management is beginning to require healthcare providers to rely heavily on big data derived from both their own health IT systems and from their business partners. Identifying patients at high risk of developing chronic diseases or falling away from maintenance protocols is a significant challenge for many organizations, but is quickly becoming…
2017 has undoubtedly been a standout year in the realms of telemedicine and digital health. In telehealth alone, much has happened over the past 12 months. A new law in Texas officially gave physicians permission to utilize telemedicine services to treat patients they haven’t met in person, quashing a previous requirement that physician-patient relationships had…