First catheters, now skin substitutes—and more areas of anomalous medical billing will continue to pop up, requiring data vigilance and collaboration on the part of accountable care organizations (ACOs), according to speakers at the National Association of ACOs (NAACOS) Spring 2025 Conference. The identification of these areas potentially signaling fraud aligns with the Trump administration’s…
Download Slides Join TCARE and Isaac Health for a webinar showcasing their partnership in the CMS GUIDE Model, which delivers comprehensive support for both individuals with dementia and their caregivers. Isaac Health provides expert-led dementia care, including personalized treatment plans, 24/7 telehealth access, and care coordination for patients. Meanwhile, TCARE supports caregivers with evidence-based…
A new partnership aims to strengthen accountable care models in health care practices around the country. AMGA, the American Medical Group Association, and Wilmington Health announced a partnership to start the AMGA Value Care Network. It is a new strategic initiative and collaboration to “deliver scalable solutions that empower AMGA member organizations to thrive in value-based care environments.” “We…
Will the U.S. healthcare system achieve a technological breakthrough, or will another promising tool die on the vine due to medicine’s illogical financial model? That was the question I set out to answer this morning from the main stage of the 10th annual Accountable Care Symposium in Orlando, Florida—an event hosted by Wellvana, one of…
Download Slides In today’s dynamic Medicare Advantage landscape, staying competitive requires innovative strategies and proactive engagement, driven by real-time data. Join us for an insightful webinar where we’ll explore cutting-edge approaches to HEDIS and quality management, informed by real-world experiences and powered by the latest technologies.This session will provide you with actionable strategies to…
Even as most value-based payment (VBP) models fail to generate savings, public officials and industry leaders tout the ostensible success of Medicare’s accountable care organizations (ACOs). In a recent Health Affairs Forefront article, Biden Administration officials celebrated the $2.1 billion in savings in 2023 in the signature Medicare Shared Savings Program (MSSP), marking five years…
Before competing in Olympic swimming, it’s important to start with basic lessons; similarly, behavioral health providers may consider taking strategic intermediate steps before becoming fully at-risk providers. The move from a fee-for-service model toward risk-based value-based care can be gradual for behavioral health providers. There are a number of alternative payment models that providers can…
Next year the State of Maryland will transition from its unique Total Cost of Care (TCOC) payment model to the CMS AHEAD (States Advancing All-Payer Health Equity Approaches and Development) model. The state’s Health Services Cost Review Commission (HSCRC) recently heard testimony from a variety of stakeholders about their hopes and concerns for AHEAD. Under a…
Only one-third of the models analyzed produced substantial savings for the federal government, according to Avalere Health. Dive Insight: The CMMI was created by the Affordable Care Act to test new payment and care delivery models in a bid to lower costs and improve quality in government healthcare programs. Most models have focused on Medicare, the…
Download Slides Fraud, waste, and abuse (FWA) cost healthcare payers billions every year, negatively impacting operational efficiencies. Is your organization ready to detect, prevent, and effectively combat these issues? Join us for this valuable session to gain actionable insights for strengthening your company’s defenses against FWA. We’ll walk you through the essential steps of…