RECORDED WEBINAR: How the CMS National Quality Strategy Can Guide You on Your Value-Based Care Journey, Part Three

Garrett SchmittNo Comments, ,

 Download Slides To remain competitive, ACOs, Medical Groups, and Physician Networks must control costs, while simultaneously delivering excellent care. Creating a long-term transformation strategy that harmonizes primary and speciality services into whole-person care that fulfills these objectives can be a daunting task, particularly at the beginning of your value-based care journey. However, there’s no need to…

RECORDED WEBINAR: Surviving and Thriving Under the Persistent Movement to Value Based Care Arrangements

Garrett SchmittNo Comments, , ,

 Download Slides Value-based care (VBC) arrangements between payers and providers continue to grow, fueled by the Center for Medicare and Medicaid’s (CMS’) ambitious goal of achieving 100% accountable care for Medicare beneficiaries by 2030. To be successful under these arrangements, provider organizations need to understand the VBC landscape and the levers they have available…

Future-Proofing Risk Adjustment: 3 Essential Changes to Embrace Today

Garrett Schmitt

It’s 2024, and we’re living in a digital world. Yet far too many healthcare providers are making do with outdated and incomplete methods for collecting, analyzing, and using medical records. With the rollout of CMS-HCC V28, the publication of TEFCA 2.0, and the continued push for national interoperability, now is the time for value-based care…

The Rise of Value-Based Specialty Care

Garrett Schmitt

Value-based specialty care can help transform care delivery and improve patient experiences and outcomes, so it’s no surprise that it has been major topic of conversation this year. A common refrain heard at healthcare conferences and in industry media is that value-based specialty care is coming, and healthcare organizations can either get on board or…

Bringing value-based care to the youngest patients

Garrett Schmitt

Pediatrics has been at the forefront of preventive medical practices such as immunizations, screenings, care coordination with specialists and meeting defined health goals. Measurable prevention is a major cornerstone of providing value-based care, so it would seem the approach would pair well with pediatrics. But it’s not that simple, because there is a wide range…

‘The Safe Discharge’: Challenges Behind Balancing Care and Cost in Value-Based Care at Nursing Homes

Garrett Schmitt

Reimbursement issues at nursing homes are pushing operators to adapt their payment models to increase reliance on Institutional Special Needs Plans (I-SNPs) and Accountable Care Organizations (ACOs). But while these models aim to enhance care quality even as they control costs, they also bring on unique challenges, including requiring extra oversight with discharges and related…

Capitation Technology Drives Financial Viability in Value-Based Care Models

Garrett Schmitt

Many healthcare delivery organizations have adopted some form of value-based payment model in recent years, shifting the healthcare focus from quantity of services to quality of outcomes. In a promising trend for healthcare overall, more than half of healthcare payments in 2023 were part of a value-based care reimbursement model. Capitation – which provides a set fee per…

Best Practices for Implementing AI Into Value-Based Care

Garrett Schmitt

The benefits of artificial intelligence (AI) include predictive analytics, personalized treatment plans, operational efficiency, and and remote patient monitoring, says Liz Kwo, MD, MBA, MPH, chief commercial officer, Everly Health; faculty lecturer, Harvard Medical School, and author of the book, DigitalMD. This transcript has been lightly edited. Transcript How can AI effectively contribute to value-based…

NAACOS praises CMS proposed rule on accounting for alleged catheter billing fraud

Garrett Schmitt

Allegations of fraudulent billing for catheters in 2023 will not affect calculations when Medicare analyzes financial performance of accountable care organizations (ACOs). The U.S. Centers for Medicare & Medicaid Services (CMS) has opened a 30-day public comment period on its “Proposed Rule on Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on…