RECORDED WEBINAR: How the CMS National Quality Strategy Can Guide You on Your Value-Based Care Journey, Part One

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 Download Slides To remain competitive, ACOs, Medical Groups, and Physician Networks must control costs, while simultaneously delivering excellent care. Creating a long-term transformation strategy that harmonizes primary and speciality services into whole-person care that fulfills these objectives can be a daunting task, particularly at the beginning of your value-based care journey. However, there’s no need to…

NQF Study: Improvement on Two Quality Measures Could Save 144,000 Lives

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A study from the National Quality Forum (NQF) estimates that approximately 144,000 lives could be saved over 10 years by improving just two key areas of quality: colorectal cancer screening and blood pressure control. The study, published in Health Affairs Scholar, used national data to estimate the impact of improved performance on two specific quality…

How Can Bundled Payments Be Incorporated Into ACOs?

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A new report says that capturing participant experiences in both the Bundled Payments for Care Improvement (BPCI) Advanced Model and ACO models can help inform how bundled payments might be incorporated into ACOs in the future. In Model Year 4, the BPCI Advanced Model, which began in 2018 and is scheduled to conclude in 2025,…

CMMI Refines and Extends Enhancing Oncology Model

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On May 30, the Centers for Medicare & Medicaid Services announced the opening of a second round of applications to join the Enhancing Oncology Model (EOM) in July 2025. The application portal to apply will open in July 2024. EOM is a voluntary payment model intended to transform care for cancer patients. EOM aims to…

The Vital Role of Hospitals in Tackling Health Inequities

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Many people face health challenges due to unmet social needs, such as food insecurity, unstable housing, or lack of transportation. These social factors, or health-related social needs, can reduce a person’s wellbeing, and make it difficult to manage chronic conditions, recover from illness or maintain overall good health. Rural and urban hospitals and health systems…

What is TEFCA?

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Though the Trusted Exchange Framework and Common Agreement (TEFCA), is a relatively new development in healthcare, it has major implications for every healthcare organization and its patients. ‍In short, TEFCA outlines the terms and conditions that will allow for the exchange of electronic health information (EHI) across different Health Information Networks (HINs). This will make…

The Value-based Care Throughline to Healthcare Quality and Safety

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Before the pandemic, hospitals in the U.S. were making notable progress in the effort to  address flagging patient safety and care quality metrics. And that effort paid off — adverse events and safety and quality issues plummeted in the decade before Covid-19. But the latest numbers available demonstrated a reversal in that trend, as hospitals…

For Rural ACOs, New Primary Care Model From CMS Offers Much-Needed Financial Help

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To provider organizations, the Change Healthcare hack in February was a painful reminder of a lesson learned during the first year of the COVID-19 pandemic: A disruption in revenue flow can lead to financial disaster or even closure. Many smaller hospitals and medical offices have struggled to get paid since the ransomware attack shut down…

Does physician-hospital integration reduce ACO cost?

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The answer is ‘yes’ from a paper by Lin et al. (2024). Using 2009-2013 data from the Massachusetts All-Payer Claims Database, the authors measured physician–hospital integration within an accountable care organization (ACO) based on the proportion of primary care physicians (PCPs) in an ACO who billed for outpatient services with a place-of-service code indicating that…

2022 QPP Experience Report: Address 3 Key Findings Now To Avoid Future Penalties

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At first glance, CMS’s recently released 2022 QPP Experience Report (PDF) seems reassuring, because the majority of clinicians avoided financial penalties under MIPS. Don’t be fooled! While overall success and failure rates in the report may lead you to conclude that merely participating in the QPP (either in MIPS or as an APM) is enough…