In 2023, the 132 participants in the ACO REACH model generated $1.6 billion in gross savings and $695 million in net savings after accounting for shared savings and losses, according to the Centers for Medicare & Medicaid Services. NAACOS, the National Association of Accountable Care Organizations, congratulated the ACO REACH participants, while urging CMS to…
Interoperability has been a hot topic in the healthcare industry for over a decade and is a constantly recurring theme for organizations as they evaluate potential future technologies and how adopting those technologies will help them meet compliance requirements. The most urgent compliance concerns relate to the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F),…
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 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 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…
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…
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…
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….
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…
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…