The Centers for Medicare & Medicaid Services (CMS) recently announced updates to the Accountable Care Organization (ACO) “REACH” Model, which provides private home-focused health care providers with an opportunity to participate in risk-sharing agreements with traditional Medicare. The new updates are essentially “tweaks” based on learnings acquired through the first two years of the program’s…
Download Slides Do you know the business impact patient referrals have on your bottom line or value-based outcomes? More importantly, what are you doing to ensure referrals are supporting your VBC and FFS initiatives? What if your organization was able to effectively leverage referral automation and data within your EHR to reduce Leakage by…
Poorly managed and uncontrolled chronic diseases are the leading cause of death and disability in the United States, and represent a growing national crisis. Five of the top 10 causes of death – heart disease, cancer, diabetes, obesity, and hypertension – are chronic conditions, or closely linked to preventable and treatable chronic conditions. The prevalence of these…
A new study in Health Affairs Scholar suggests that value-based care (VBC) models, when paired with strong practice support, may help primary care practices keep their doors open to more Traditional Medicare patients — even as access shrinks nationwide. Analyzing Medicare claims from 2019 to 2023, researchers found that primary care physicians (PCPs) who adopted a full-risk, multipayer VBC model in…
Value-based care, independent and rural physicians, and lifestyle choices all will have a role in Making America Healthy Again, according to Medicare’s top leaders. Mehmet Oz, MD, MBA, administrator for the U.S. Centers for Medicare & Medicaid Services (CMS), presented the agency’s plan with CMS Deputy Administrator Abe Sutton, JD, director of the CMS Innovation Center, and Gita Deo,MPH,…
To meet its goals of controlling costs and improving patient care, Value-Based Care requires a near-universal, multi-payer strategy. Only when payment incentives induce cost-effective health care for all patients, as well as provider accountability and patient engagement, will we get that result. Incremental adoption of value-based payments is instructive, but this approach lacks impact when…
Symbion Coding partners with medical organizations to develop tailored solutions they need to enhance their operations, improve compliance, and achieve accurate financial results. Founded in 2015, Symbion Coding has worked with several clients to optimize their coding and billing compliance, improve their coding accuracy, and unlock millions of dollars in revenue. Symbion Coding understands the…
A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. Later this summer, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been and…
“Value-based care” (VBC) is one of the most frequently cited goals in U.S. healthcare reform — yet its meaning remains frustratingly vague and often contradictory. We hear that value-based care is the future. But as we navigate payment reforms, new quality programs, and evolving care models, we’re forced to ask: Whose definition of “value” are we…
Electronic Clinical Quality Measures (eCQMs) are revolutionizing the way healthcare organizations evaluate care quality, track patient outcomes, and meet regulatory requirements. By embracing digital solutions, providers can not only streamline reporting processes but also deliver higher-quality care tailored to individual needs. This blog combines practical steps for eCQM implementation with the latest trends shaping their…