Formerly U.S. Medical Management, the home-based care company HarmonyCare raised $200 million in June. On Wednesday, it touted its success in the Accountable Care Organization (ACO) “REACH” Model, the successor to the The Global and Professional Direct Contracting Models (GPDC). Put forth by the Centers for Medicare & Medicaid Services (CMS), ACO REACH gives private…
As healthcare reimbursement models shift towards value-based care (VBC), chief financial officers (CFOs) are increasingly at the forefront of managing the financial implications of these changes. Not only are CFOs instrumental in assessing and mitigating the risks associated with new contracting models, but they are also responsible for ensuring that their organizations can thrive in…
Health care leaders emphasized the need for collaboration, data standardization, and an iterative, patient-centric approach to advance value-based care (VBC) during a panel discussion at the Council for Affordable Quality Healthcare (CAQH) Connect 2024 in Washington, DC. The discussion, titled “Value Based Care: The Next Evolution,” included panelists Todd Couts, MS, deputy director of the…
Among the nation’s 453 ACOs, Providence’s Health Connect Partners generated the highest shared savings for Medicare in 2023 with $137 million saved through its senior program. After accounting for shared savings and losses, 132 ACOs collectively generated nearly $695 million in net savings, according to CMS and the National Association of ACOs. In 2023, Medicare…
Palliative care providers that form collaborative partnerships with Accountable Care Organizations (ACOs) may be lending to a landmark downward trend in health care spending in the value-based payment landscape. The U.S. Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion net savings in…
In 2023, the 132 participants in the ACO REACH model generated $1.6 billion in gross savings and $695 million in net savings after accounting for shared savings and losses, according to the Centers for Medicare & Medicaid Services. NAACOS, the National Association of Accountable Care Organizations, congratulated the ACO REACH participants, while urging CMS to…
Interoperability has been a hot topic in the healthcare industry for over a decade and is a constantly recurring theme for organizations as they evaluate potential future technologies and how adopting those technologies will help them meet compliance requirements. The most urgent compliance concerns relate to the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F),…
The healthcare industry is slowly moving away from fee-for-service care models and toward value-based care — but contracting in these arrangements remains especially difficult for behavioral health providers, according to Taft Parsons III, chief psychiatric officer at CVS Health/Aetna. He highlighted this issue during a panel discussion on Tuesday at the Behavioral Health Tech conference…
The healthcare industry is slowly moving away from fee-for-service care models and toward value-based care — but contracting in these arrangements remains especially difficult for behavioral health providers, according to Taft Parsons III, chief psychiatric officer at CVS Health/Aetna. He highlighted this issue during a panel discussion on Tuesday at the Behavioral Health Tech conference…
The 2025 CMS PFS Rule landed with a bang, and it’s not just the weight of the 3,088 pages. We’re one year closer to 2030, the year that CMS intends to have all Traditional Medicare patients in a relationship with a clinician who is accountable for total cost of care. The push to the finish…