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CVS Health Exec: Payers Need to Stop Making Behavioral Health Providers Jump Through Hoops In Order to Participate in Value-Based Care

November 7, 2024Garrett Schmitt

The healthcare industry is slowly moving away from fee-for-service care models and toward value-based care — but contracting in these arrangements remains especially difficult for behavioral health providers, according to Taft Parsons III, chief psychiatric officer at CVS Health/Aetna. He highlighted this issue during a panel discussion on Tuesday at the Behavioral Health Tech conference…

CVS Health Exec: Payers Need to Stop Making Behavioral Health Providers Jump Through Hoops In Order to Participate in Value-Based Care

November 7, 2024Garrett Schmitt

The healthcare industry is slowly moving away from fee-for-service care models and toward value-based care — but contracting in these arrangements remains especially difficult for behavioral health providers, according to Taft Parsons III, chief psychiatric officer at CVS Health/Aetna. He highlighted this issue during a panel discussion on Tuesday at the Behavioral Health Tech conference…

The 2025 CMS PFS Final Rule: The Five-Pronged Strategy Towards Comprehensive Accountable Care

November 6, 2024Garrett Schmitt

The 2025 CMS PFS Rule landed with a bang, and it’s not just the weight of the 3,088 pages. We’re one year closer to 2030, the year that CMS intends to have all Traditional Medicare patients in a relationship with a clinician who is accountable for total cost of care. The push to the finish…

Why Accurate Provider Data Can No Longer Be Overlooked in Value-Based Care

November 6, 2024Garrett Schmitt

In Spring 2023, AMA President Dr. Jack Resneck, Jr. sat before the Senate Finance Committee and discussed the critical state of physician directories, which are, by all accounts, riddled with inaccurate data. To demonstrate, on the morning of the hearing, the committee’s chair, Senator Ron Wyden, released the results of a study in which phone…

How Hospices Can Leverage Palliative Care to ‘Stay Relevant’ in Value-Based Care

November 6, 2024Garrett Schmitt

U.S. health care is moving steadily towards value-based reimbursement, and having a robust palliative care program can help hospices ensure they are not left behind. The U.S. Centers for Medicare & Medicaid Services (CMS) is working to ensure that 100% of Medicare beneficiaries are aligned with a risk-based payment model by 2030. This can include…

Can the ACO Primary Care Flex Model help link physical and mental healthcare?

November 6, 2024Garrett Schmitt

The connection between behavioral health and physical health is well-documented. Physical health is greatly affected by such behaviors as smoking, substance abuse, poor diet, lack of exercise, insufficient sleep and more. In addition, mental health issues and social determinants of health, such as lack of housing or transportation, language barriers, and food insecurity, impact health….

Helping make value-based care work for primary care

November 6, 2024Garrett Schmitt

Value-based care has been heralded as the future of healthcare for more than a decade, but it has yet to fully arrive. This gap is particularly evident in primary care, which must be on board if the promise of value-based care (VBC) is to be achieved. The Commonwealth Fund, a private U.S. foundation dedicated to…

Your ACO May Already Be Late For APP Reporting. Here’s How To Catch Up!

November 5, 2024Garrett Schmitt

With one year remaining before mandatory APP Reporting in 2026, the idea that you’re already late may sound exaggerated. But consider the significance of what you’re undertaking: This is your first effort to report quality on all your beneficiaries, not just a tiny sliver of patients. It’s a huge leap that requires a lot of…

Farzad Mostashari, M.D.: The MSSP Is Absolutely Proving Itself

November 5, 2024Garrett Schmitt

Many healthcare leaders were elated when officials at the Centers for Medicare & Medicaid Services (CMS) on October 29 released the 2023 calendar-year results for the Medicare Shared Savings Program (MSSP), the program run by the Medicare program with the largest number of participating accountable care organizations (ACOs). As the press release from CMS on…

How AI Can Drive the Transition to Value-Based Care

November 1, 2024Garrett Schmitt

The healthcare industry is at a crossroads, grappling with the dual challenges of declining health quality metrics and skyrocketing care costs. The reality is that health outcomes are driven more by what patients do than by what providers or payers do. It is estimated that 80% of health outcomes are driven by non-medical factors –…

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