As the healthcare landscape continues to evolve, there’s a clear trend towards value-based care (VBC). This significant shift, which places a premium on patient health outcomes, diverges from the traditional fee-for-service approach. The aftermath of the COVID-19 pandemic has mainly catalyzed the adoption of VBC models, highlighting the importance of care quality and effectiveness rather…
With the push towards health equity and away from a fee-for-service model of healthcare, risk-bearing organizations have an opportunity to join the ACO REACH (Realizing Equity, Access, and Community Health) program. In the program, Centers for Medicare & Medicaid Services (CMS) encourages ACO REACH participants to work with underserved communities. Further, the program guidelines mandate…
Download Slides Are you worried about the burden of APP reporting? Do you feel that data aggregation and all-patient reporting is too expensive and risky, but Medicare CQMs seems like a lot of extra work? Let’s examine your options for APP Reporting from a cost and burden standpoint, and see what will be the most…
Dive Brief: Accountable care organizations in traditional Medicare are prospering, federal regulators said in new data released Monday. However, participation in Medicare’s largest value-based care program has stayed generally the same over the last five years. Roughly 13.7 million Medicare patients this year — nearly half of beneficiaries on traditional Medicare — are in accountable care…
The Coding Intensity Factor (CIF) is intended to establish revenue neutrality in the Realizing Equity, Access, and Community Health (REACH) program and causes all accountable care organizations (ACOs) to pay for increases in program-wide risk scores. Because the CIF is calculated after the application of the +/-3% floor and ceiling, some REACH ACOs could contribute…
When I was 14 years old, my parents moved our family home within Miami Dade County. We shifted from zip code 33157 to 33183, and as I’ve recently learned, this increased our life expectancy from ~79 years to ~86 years. My parents didn’t have a college education or any access to this type of data,…
In 2024, 50 accountable care organizations are new to the Medicare Shared Savings Program (MSSP) and 71 ACOs renewed participation, according to new numbers released by the Centers for Medicare & Medicaid Services (CMS) Monday. The total number of participants now stands at 480 ACO programs, with 245 organizations continuing in ACO REACH and the…
Officials at the federal Centers for Medicare and Medicaid Services (CMS) announced on Jan. 29 the latest numbers for participation in accountable care organization (ACO) programs it sponsors, with a total of 480 ACOs now participating in the Medicare Shared Savings Program (MSSP), the largest number to date. In addition, CMS officials announced on Monday…
To turn the tide around on the growing teen mental health crisis, the U.S. needs to overhaul the current behavioral health system, experts argued on a virtual panel, sponsored by Big Health, mid-January. Among the suspected drivers of the worsening crisis are social media and COVID-era isolation, which have led to a lack of socialization…
While medical coding may not be at the forefront of innovation priorities for some healthcare systems, there is real opportunity for care delivery improvement and systemic cost savings. Instead of perceiving coding solely as a necessary mechanism for fee-for-service reimbursement, progressive healthcare leaders are viewing coding as a catalyst for advancement in population health, value-based…