Fortune 500 company DaVita is one of the largest kidney care companies in the United States. It has about $5 billion at risk in value-based contracts and is on a pathway to have about $10 billion at risk for patients with kidney disease. Jeff Giullian, M.D., chief medical officer at DaVita, recently spoke with Healthcare…
The healthcare industry’s movement away from fee-for-service care models and toward value-based care has been an incredibly gradual process. Contracting in these arrangements remains difficult for providers and payers, and clinicians continue to struggle with the administrative burden that comes along with delivering value-based care. Three healthcare experts shared their thoughts on this issue last…
According to the Primary Care Collaborative’s (PCC’s) 2024 Evidence Report, “Primary Care: The MVP of MSSP,” primary care-centric accountable care organizations (ACOs) provide better quality health outcomes and generate 2.4 times higher savings, compared to their peers. The 2024 Evidence Report, written in collaboration with Robert Graham Center and Simple Healthcare, considered more than six…
As the health care industry increasingly adopts value-based care (VBC) models, providers face the dual challenge of enhancing patient outcomes while controlling costs. To succeed in this environment, integrating health plan data — such as claims, enrollment and care gap information — into clinical and operational workflows is essential. By combining health plan data with…
We have a lifelong relationship with our health. We depend on others to help finance our health risks through insurance, doctors to advise and treat us, drug companies to create treatments, and hospitals to house and care for us when we are in our worst health. Accountability is both an individual and a shared responsibility….
The Centers for Medicare & Medicaid Services (CMS) 2025 Physician Fee Schedule (PFS) Final Rule brings notable updates to the Quality Payment Program (QPP), which will impact eligible clinicians, groups, virtual groups, subgroups, and APM entities. Whether you’re participating through MIPS, MVPs, or an ACO, these changes offer opportunities to streamline reporting, leverage new scoring…
The first regional event of Institute for Value-Based Medicine,® {IVBM), held in Boston, Massachusetts, in September 2024, brought together top minds from the top cancer centers in Massachusetts and Connecticut to examine the fine line between wanting to take value-based cancer care to the next level and considering how to bring advancements in precision medicine…
NextGen Healthcare, a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged its NextGen® Population Health solution to achieve a cumulative $102 million in total Medicare savings last year. The MSSP incentivizes hospitals, physician associations, and other healthcare facilities to form accountable…
Darrin Menard, M.D., medical director of the Louisiana Medicare Shared Savings Program (MSSP) Enhanced ACO, recently described how his accountable care organization has evolved to become more successful in the program. Menard, a practicing family medicine physician in Scott, Louisiana, was speaking at a Primary Care Collaborative event focused on their new report, “Primary Care:…
Oncology practices that participated in two-sided risk in the latter half of the Oncology Care Model (OCM) were the main driver of payment reductions in the model, according to an evaluation prepared for the Center for Medicare & Medicaid Innovation. In February 2015, the Centers for Medicare & Medicaid Services (CMS) invited oncology physician group…