Value-based care is transforming the health care landscape as some health systems shift focus toward outcomes-driven payment models. In this evolving paradigm, physicians and other health professionals are rewarded for improving patient health outcomes rather than the volume of services they deliver. This shift is designed to enhance care quality, reduce costs and improve patient…
Medicare Advantage (MA) star ratings have become a hot topic for Humana Inc. (NYSE: HUM). On Oct. 18, the company filed a lawsuit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) over its drop in star ratings. The number of Humana MA plans rated…
The Medicare Shared Savings Program achieved over $2.1 billion in net savings for Medicare in 2023 — the largest savings in its decade-long history, according to the Centers for Medicare & Medicaid Services (CMS). In addition to cost savings, Accountable Care Organizations (ACOs) participating in the program have raised the bar in quality of care….
The Medicare Shared Savings Program (MSSP) continues to deliver meaningful savings while supporting high-quality health care, according to CMS.1 In 2023, the program saved Medicare more than $2.1 billion, while Shared Savings program Accountable Care Organizations (ACOs) helped deliver high-quality care and support CMS policies to enhance primary care, expand access to accountable care to…
In the wake of an important update from the Centers for Medicare & Medicaid Services (CMS) on the Medicare Shared Savings Program (MSSP), one of the nation’s leading associations representing physician groups involved in value-based contracting has released a press release focusing on the strong contribution of medical groups focused on primary care, to that…
The news coming out of the Centers for Medicare & Medicaid Services (CMS) this week was all good. What might that mean in the context of an uncertain and complex political landscape around healthcare generally and around value-based contracting more specifically? Well, to begin with, the news coming out of the federal government on Oct….
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…