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…
Value-based payment (VBP) — which ties health care reimbursement to quality and cost outcomes — has gained traction across the health care sector. Primary care providers participating in VBP arrangements have often performed well, likely due to their focus on prevention and cost-efficient care. However, community health centers (CHCs), which provide primary care to more than…
There is an eagerness across the behavioral health industry to transition from fee-for-service into value-based contracts. But, at times, this urgency can actually be a hindrance instead of a help, industry insiders recently explained at the Behavioral Health Business VALUE conference. Crafting value-based care infrastructure, understanding how and what to measure and defining the mechanisms…
In value-based care models, pharmacists play an important role in multidisciplinary team care in selecting cost-effective treatments and managing adherence to prevent hospitalizations and emergency department (ED) visits, explained Eileen Peng, PharmD, vice president, chief administrator, and pharmacy officer, Astera Cancer Care. Full Article
Behavioral Health Business: I’m going to introduce our panelists here. I’ve got Michael Frisby, the Chief Growth Officer at Sandstone Care; Melissa McCarthy, Co-founder and Managing Partner at The Reprieve; and Lindsay Beasley, Director of Solutions Engineering at Sunwave. I’m going to sit down and enjoy the conversation with you all. Take it away. Michael Frisby: Great….
Aledade and other accountable care organizations are pressing the Centers for Medicare & Medicaid Services to correct what they say is a major misstep in a financial benchmark model that could significantly reduce their earnings and possibly force some practices out of value-based care and discourage others from joining. The controversy centers on CMS’s Accountable…
In 2024, the Centers for Medicare and Medicaid Services (CMS) implemented important changes to how spending targets, known as benchmarks, are set in the Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs) entering new five-year agreement periods. Among these, CMS introduced an Accountable Care Prospective Trend (ACPT) into the formula for updating MSSP…
The Centers for Medicare & Medicaid Services (CMS) revealed several updates to the ACO REACH program in 2026, though the model’s long-term future remains unclear. The CMS said it is making changes to the model based on preliminary data on 2023 performance, which found that standard accountable care organizations saved $197.5 million in aggregate that…