In the U.S. health system, various determinants and factors such as income, race, education, gender, sexuality, and even zip code significantly influence our health outcomes. These factors affect how healthy we are, the frequency and severity of illnesses, our access to care, and even our life expectancy. Consider these stats: Non-Hispanic Blacks/African Americans have 2.4…
Accountable care organizations (ACOs) face unique burdens to comply with CMS’s new quality reporting requirements as summarized in this 2021 MedCity News article. Challenges are particularly acute for ACOs that delayed conversion from CMS’s Web Interface to the new electronic clinical quality measures (eCQM) quality reporting. Many ACOs have made the change. But many have…
Meticulous documentation is the name of the game for nursing home operators looking to keep up with Minimum Data Set (MDS) changes and maintaining a good rating in the Five-Star Quality Rating System. This is especially because inaccurate or insufficient data could affect a facility for at least a year in the future. Leaders in…
Momentum for value-based care grows as physicians gain more experience with value-based models and commit to improving outcomes – rewarding patients and providers alike. Investing in value-based care allows physicians to spend more time with their patients and, in doing so, deliver high-quality care that takes patients’ needs and preferences into consideration. Patients, providers and…
Accountable care organizations (ACOs) need better communication to explain how they are helping Medicare patients achieve better health at a better overall cost. The National Association of Accountable Care Organizations (NAACOS) and the Health Care Transformation Task Force published “Reimagining Beneficiary Engagement in Accountable Care Models.” The white paper outlines how ACOs, the longest-standing alternative…
In the rapidly evolving landscape of healthcare, staying ahead of regulatory changes and quality reporting requirements is crucial for both Accountable Care Organizations (ACOs) and clinicians participating in the Quality Payment Program (QPP). The Centers for Medicare & Medicaid Services (CMS) has introduced significant proposals that impact the Medicare Shared Savings Program (MSSP) and the…
The Commonwealth Fund has published the results of a study seeking to understand why more primary care practitioners (PCPs) are not participating in value-based payment (VBP) models. After conducting focus groups with PCPs who have not participated in VBP models and interviews with primary care executives and association leaders, the report offers some recommendations about…
As we move through the second half of 2024, managed care organizations must prioritize member engagement, especially for individuals with chronic conditions. This period presents an opportunity to embrace strategies that encourage essential healthcare visits, such as annual wellness and primary care appointments. Read on for member engagement tactics that focus on precise member identification,…
Abstract Issue: During the past 14 years, the federal government and states have fielded numerous value-based payment (VBP) models for primary care to move away from a fee-for-service payment model that incentivizes the delivery of more services over better-quality care. However, most primary care practitioners (PCPs) do not participate in VBP models, and the reasons…
Download Slides More than six months into the CMS-HCC V28 rollout, it’s clearer now than ever before that we need true national interoperability. In this webinar, Credo Founder and CEO Carm Huntress will provide an overview of TEFCA and the current state of interoperability. He’ll also explain how AI can help solve some of…