On October 23, CMS released the results and public use file for Global and Professional Direct Contracting (now known as ACO REACH)’s 2022 performance year. The program had 99 participating ACOs in 2022, of which 81 ACOs attained gross savings and 75 ACOs attained net savings (after applicable discounts, CMS shared savings, sequestration, and risk…
Highlights: Policymakers must recognize the unique payment arrangements of safety-net providers in order to better serve rural and underserved patients through value-based care. CMS should modify its APMs through the use of waivers specific to safety-net providers or develop new ACO tracks/total cost of care models focused on rural and underserved populations. NAACOS convened members…
The health care landscape looks vastly different than it did a few years ago. Despite seemingly insurmountable challenges such as consolidation, staffing shortages, and numerous public health threats, primary care is confronting these shifts head-on while continuing to be a pillar of unwavering support in our health care system. The road ahead is bright, especially…
The Centers for Medicare and Medicaid Services has announced a new model to test approaches for addressing behavioral and physical health, as well as social needs, for people with Medicaid and Medicare. The model will launch in the fall 2024 and is anticipated to operate for eight years in up to eight states. CMS is…
The evolving landscape of value-based care (VBC) in 2024 is witnessing a dynamic shift, driven by nuanced changes that hold the promise of transforming healthcare delivery, quality assessment, and reimbursement methodologies. Here are the key trends that will need to be top of mind for provider organizations that are transitioning to VBC, or looking to…
Value-based care has been cited as a way to reduce healthcare costs and improve outcomes. However, adoption has been slower in rural communities, with rural providers facing several uphill challenges, according to one health company executive. “Providers I’d say have been a bit more resistant in rural areas to take on risk, to take on…
Generally, home health agencies have expressed dissatisfaction with payment rates and reimbursement policies set by managed care companies. Negotiations around rates can often be contentious. In 2024, however, providers can win with the correct focuses in mind. “You don’t want a managed care strategy; you want a value-based care strategy,” Anne Tumlinson, founder and CEO…
Often the key to solving a troublesome problem is approaching it from a different direction. As 19th-century mathematician Carl Gustav Jacob Jacobi wisely noted (and as popularized by renowned investor Charlie Munger), “Invert, always invert.” Therefore, when we consider ways to transform our current health care system in the U.S. to deliver more reliable, equitable,…
No ‘one-size-fits-all’ strategy Practice infrastructure can be a significant factor in the success of musculoskeletal value-based care models. Value-based care models aim to improve the quality of health care while controlling costs, often by shifting from fee-for-service reimbursement to payment models that reward health care providers for delivering high-quality, best outcomes and cost-effective care.
Abstract Introduction Value-based healthcare (VBHC) focusses on increasing value for patients. Hospitals aim to implement VBHC via value improvement (VI) teams for medical conditions. To determine the patient’s perspective on value, collective patient participation is important in these teams. We therefore evaluated the current state of patient participation in VI teams and share lessons learned….