Dive Brief: Accountable care organizations in traditional Medicare are prospering, federal regulators said in new data released Monday. However, participation in Medicare’s largest value-based care program has stayed generally the same over the last five years. Roughly 13.7 million Medicare patients this year — nearly half of beneficiaries on traditional Medicare — are in accountable care…
The Coding Intensity Factor (CIF) is intended to establish revenue neutrality in the Realizing Equity, Access, and Community Health (REACH) program and causes all accountable care organizations (ACOs) to pay for increases in program-wide risk scores. Because the CIF is calculated after the application of the +/-3% floor and ceiling, some REACH ACOs could contribute…
When I was 14 years old, my parents moved our family home within Miami Dade County. We shifted from zip code 33157 to 33183, and as I’ve recently learned, this increased our life expectancy from ~79 years to ~86 years. My parents didn’t have a college education or any access to this type of data,…
In 2024, 50 accountable care organizations are new to the Medicare Shared Savings Program (MSSP) and 71 ACOs renewed participation, according to new numbers released by the Centers for Medicare & Medicaid Services (CMS) Monday. The total number of participants now stands at 480 ACO programs, with 245 organizations continuing in ACO REACH and the…
Officials at the federal Centers for Medicare and Medicaid Services (CMS) announced on Jan. 29 the latest numbers for participation in accountable care organization (ACO) programs it sponsors, with a total of 480 ACOs now participating in the Medicare Shared Savings Program (MSSP), the largest number to date. In addition, CMS officials announced on Monday…
To turn the tide around on the growing teen mental health crisis, the U.S. needs to overhaul the current behavioral health system, experts argued on a virtual panel, sponsored by Big Health, mid-January. Among the suspected drivers of the worsening crisis are social media and COVID-era isolation, which have led to a lack of socialization…
While medical coding may not be at the forefront of innovation priorities for some healthcare systems, there is real opportunity for care delivery improvement and systemic cost savings. Instead of perceiving coding solely as a necessary mechanism for fee-for-service reimbursement, progressive healthcare leaders are viewing coding as a catalyst for advancement in population health, value-based…
American healthcare is highly inefficient. Across a variety of long-term health and treatment outcomes and patient safety metrics, the U.S. has lower performance compared with countries of similar economic status, despite spending more money per capita than its peers. In 2022, the U.S. spent an estimated $12,555 per person on healthcare — the highest among…
The Ohio State University Wexner Medical Center and CVS Accountable Care, a part of CVS Health, have announced the creation of an accountable care organization for a coordinated approach to delivering care. The new CVS ACO is a Medicare Shared Savings Program Enhanced track ACO. CVS Accountable Care was formed last year as a result…
A 360-degree view of the patient is essential in providing clinicians, payers, and patients themselves with actionable insights that can lead to improved outcomes. Artificial intelligence (AI) is increasingly playing major roles in data digitization, prediction analytics, and decision support systems. For example: AI technologies like NLP (Natural Language Processing) and computer vision enable the…