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…
Carle Health, a vertically integrated health system, and Lumeris, a leading value-based care enablement company, today announced a strategic partnership to improve healthcare delivery and patient outcomes through value-based care for communities in Central Illinois. The partnership will transform care delivery for Medicare populations by integrating Lumeris’ comprehensive technology solutions and population health management tools…
Interwell Health, a value-based kidney care management company, is proud to announce the launch of Acumen Rounder, the first and only nephrology rounding application that tightly integrates with Epic. The application works seamlessly with Acumen Epic Connect, the most adopted nephrology-specific electronic health record (EHR). Acumen Rounder supports nephrologists and care teams in managing patient…
On Tuesday, Nov. 19, President-elect Donald Trump announced that he would nominate Mehmet Oz, M.D., to be the next Administrator of the Centers for Medicare & Medicaid Services (CMS). POLITICO’s Ben Leonard wrote on Tuesday afternoon that “President-elect Donald Trump has chosen Mehmet Oz, the celebrity physician and TV personality known as Dr. Oz, to…