Prevention is better than cure — this age-old adage continues to guide the healthcare industry as it moves from volume-driven to value-based care models. In value-based care models, healthcare providers are paid based on the quality of care they provide, measured by clinical outcomes, patient and provider experience and the cost of care. According to…
Researchers at University of California San Diego School of Medicine found that large language models (LLMs) can accurately process hospital quality measures, achieving 90% agreement with manual reporting. By addressing the complex demands of quality measurement, the researchers believe the findings pave the way for more efficient and reliable approaches to healthcare quality reporting. The…
Senior officials at the Centers for Medicare & Medicaid Services (CMS) announced record net savings for the Medicare Shared Savings Program (MSSP) on Oct. 29—a total of more than $2.1 billion in 2023, along with $3.1 billion in performance payments for accountable care organizations (ACOs) participating in the program. The agency posted a press release…
The Centers for Medicare & Medicaid Services (CMS) announced today that the Medicare Shared Savings Program (Shared Savings Program) continues to save Medicare money while supporting high-quality care. The Shared Savings Program yielded more than $2.1 billion in net savings in 2023 — the largest savings in the Shared Savings Program’s history. In addition, Shared…
Value-based care remains a top priority in the shifting landscape of US health care, as emphasized during a recent session at the National Association of Accountable Care Organizations (NAACOS) fall conference. The discussion brought together payers and providers to explore the challenges and opportunities in improving patient outcomes while reducing health care costs, with a…
Hypertension control is very personal for me. Yet discussing health outcomes in terms of quality metrics and value-based measures can start to feel quite impersonal. We should remember that each of the individuals that make up those populations being measured may be deeply affected by their individual metrics and the related outcomes. When I was…
The past couple of years have been rocky for companies looking to disrupt the traditional primary care model — with top retailers Walmart and Walgreens announcing that they’re winding down their primary care operations significantly. Others still stand, though the jury is out on whether they can master the tough unit economics that come along…
Download Slides If you aren’t prepared for APP Reporting because you still think that you can duck APP Reporting with a revised Final Rule, don’t put money on it! You’ve lost a lot of lead time, but you still have options for APP Reporting. It’s time for weighing last minute options to meet requirements with the most economical and efficient APP…
The famous quote “What gets measured, gets managed” is often incorrectly attributed to business guru Peter Drucker. Although Drucker may not believe that maxim entirely, when it comes to value-based care (VBC), only care quality that can be measured and reported matters. Whether it is capitated, bundled, pay-for-performance, or hybrid VBC reimbursement models, the Centers…
Inherent in their design, Accountable Care Organizations (ACOs) are responsible for the total care of their assigned patient population. Their savings are based on the overall quality, quantity, and cost of care their beneficiaries receive. This alone is no easy feat. Yet, for those ACOs participating in Centers for Medicare and Medicaid Services (CMS) programs,…