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Will AI Solve The World’s Inequality Problem – Or Make It Worse?

September 16, 2024Garrett Schmitt

We are standing on the cusp of a new technological revolution. AI is increasingly permeating every aspect of our lives, with intelligent machines transforming the way we live and work. The potential ramifications are huge – will it lead to widespread human redundancy and a dystopian future as people’s jobs are taken over by AI…

Expanding pharmacy’s role in value-based care

September 16, 2024Garrett Schmitt

People would be healthier if they took their medications as prescribed. Fundamentally, we all know this. Outcomes would improve. Quality of life and lifespans would increase. Total health care costs would recede, because healthier people require less health care services. Physicians and their teams could spend more time working with their patients on the next…

44 ACOs to know | 2024

September 16, 2024Garrett Schmitt

Accountable care organizations, or ACOs, are physician- and health system-led groups that ascertain and apply savings in healthcare delivery. These organizations often work in partnership with Medicare programs, while also providing care for private insurance patients. Each year, ACOs save patients and health systems alike millions of dollars. Ultimately, their goal is to provide excellent…

What Value Do Teaching Hospitals Provide Commercial Beneficiaries When in an ACO?

September 16, 2024Garrett Schmitt

ABSTRACT Objectives: The number of commercial beneficiaries cared for by accountable care organizations (ACOs) is growing, but the literature examining their trends is nascent. Study Design: We examined commercial claims data from 2019 to 2021 to compare beneficiaries attributed to participants in Medicare Shared Savings Program ACOs with and without a major teaching hospital. Methods:…

CMMI Transforming Maternal Health (TMaH) Model Applications Due Soon

September 12, 2024Garrett Schmitt

On June 26, the Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Transforming Maternal Health (TMaH) Model. TMaH is ten-year delivery and payment model designed to test whether effective implementation of evidence‑informed interventions, sustained by a value-based payment (VBP) model, can improve maternal outcomes and reduce Medicaid…

Four strategies to advance value-based care

September 12, 2024Garrett Schmitt

Amid rapid health care industry consolidation, a challenging cost environment, and increasing patient needs and expectations, only truly nimble health care organizations will survive and thrive. Medical groups focused on prepaid, value-based care are better positioned to innovate, develop, and invest in technologies to respond to patient needs and market dynamics. For example, value-based organizations…

Why ACOs and Other Risk-Bearing Providers Must Prioritize Contract Management

September 11, 2024Garrett Schmitt

Healthcare providers are continuing to form and invest in Accountable Care Organizations (ACOs) as a means of improving care quality and reducing costs. Some of the largest ACOs serve upwards of hundreds of thousands of patients, while, overall, 13.7 million Medicare beneficiaries are being cared for by ACOs this year, according to the Centers for…

The ‘Holy Grail’ of Palliative Care Payment Through ACOs

September 11, 2024Garrett Schmitt

As opportunities to provide palliative care through Accountable Care Organization (ACO) relationships continue to arise, operators will likely need to understand the varying types of reimbursement that exist in that arena. ACOs are groups of physicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients….

The Challenge of Living in Both FFS and Value-Based Care Worlds

September 11, 2024Garrett Schmitt

With the high costs of care in oncology, value-based care is extremely important, but the transition is challenging when providers are still being paid by fee for service, too, explained Lalan Wilfong, MD, senior vice president, value-based care, Thyme Care. Full Article

Scaling Value-Based Care: Addressing Systemic Issues With Innovative Payer-Provider Collaboration

September 10, 2024Garrett Schmitt

Better relationships between payers and providers will be key to developing successful value-based initiatives that benefit patients while addressing the concerns of both stakeholders, according to panelists at the Community Oncology Alliance (COA) Payer Exchange Summit. The panel discussion highlighted the ongoing challenges and opportunities for payers and providers to collaborate on innovative, data-driven value-based…

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