RECORDED WEBINAR: Beyond GUIDE: HCC Recapture Made Smarter, Not Harder​: Data-Driven Insights of HCC Opportunities with Minimal Impact to Workflow

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 Download Slides TP-ACO experts, Jay Simmons, MS-ISM, Vice President, Physician Services, Lauren Stuteville, RN, BSN, Transition of Care Coordinator, and HDAI’s Julie Woods, Manager of Customer Success, will share how an interdisciplinary team collaborated to successfully use HDAI’s HCC Recapture tool to address and optimize Hierarchical Condition Categories (HCCs) capture within their ACO population.​…

What Is the Potential for Value-Based Care in Dentistry?

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Caitlin Walsdorf, a partner at HealthScape Advisors, a Chartis company, recently spoke with Healthcare Innovation about a new survey-based report that explores value-based care (VBC) implementation in dentistry.  The survey was a collaboration between HealthScape, the CareQuest Institute of Oral Health and the National Association of Dental Plans. Walsdorf co-leads  HealthScape’s Ancillary Center of Excellence focusing…

CMS holds accountable care organizations harmless for ‘highly suspect’ Medicare billing

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Dive Brief: The Biden administration has finalized a rule targeting fraudulent billing in Medicare’s largest value-based care program, after concerning reports of spiking spending on urinary catheters. The anomalous billing had the potential to hurt accountable care organizations, or ACOs, in the Medicare Shared Savings Program by impairing their ability to capture shared savings. ACOs are groups…

Closing Gaps in Value-Based Cancer Care

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Linda Bosserman, MD, PhD, FASCO, FACP, medical oncologist and professor at City of Hope, identifies key gaps in value-based cancer care, emphasizing the need to balance cost and care to improve patient outcomes and quality of life. She discussed this topic at length during her presentation, “Challenges of Providing Therapeutic Excellence in Our Current System,”…

The 5 things all successful ACOs do

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The Centers for Medicare and Medicaid Services has a goal to have all traditional Medicare beneficiaries in an accountable care relationship with a provider who is responsible for their quality and total cost of care by 2030. The National Association of ACOs published ACO Drivers for Success, a report detailing the challenges and best practices…

RECORDED WEBINAR: CMS 2025 Final Rule & Proposed Mental Health Parity Rule: Regulatory Changes Providers & Plans Need to Know

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 Download Slides Join ATTAC Consulting Group as we dive into the CMS 2025 Final Rule and proposed Mental Health Parity rule and how regulatory changes may impact providers and plans. We’ll dig into the following: Mental Health Parity: Significant changes will impact provider network operations and reimbursement Provider Network Requirements: Tightened network adequacy standards…

The biggest barrier to value-based success, per 1 exec

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Resistance to change is the biggest barrier to value-based care, Monica Engel, senior vice president of Government Markets at Blue Cross Blue Shield of Minnesota, told Becker’s.  “Both organizations need to be dedicated to changing how we act and deliver care,” Ms. Engel said. “For a traditional, legacy provider, change from fee-for-service to value-based can…

RECORDED WEBINAR: Unpacking the mandatory CMS TEAM model: Overcome new rules & challenges

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 Download Slides In August, CMS introduced a new mandatory model: Transforming Episode Accountability Model (TEAM), a bundled payment initiative affecting reimbursement for five key surgical procedures. Key Takeaways:Join our webinar, Unpacking the mandatory CMS TEAM model: Overcome new rules & challenges, on Sept. 24, at 1 p.m. EST. During this one-hour session, you’ll learn:…

CMMI’s Latest Payment Models Address Health Disparities, but Challenges Remain

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The federal government has been increasing efforts to tackle health care disparities by linking payment models with social determinants of health.1 In July, The Center for Medicare and Medicaid Innovation (CMMI) announced a new area-level Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) measure for program year (PY) 2025, replacing the PY2024…

Value-based care could improve U.S. health care quality, but may not decrease administrative complexity, experts say

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As the United States trails in rankings of health care systems of developed nations, value-based care could improve patient outcomes, but might not smooth out administrative efficiency. This week, The Commonwealth Fund published its latest “Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System.” The report shows the U.S. health care is falling…