With the current administration of President Joe Biden, the U.S. Centers for Medicare & Medicaid Services (CMS) continue to make health equity a key aspect of value-based care. Studies are increasingly detailing how the conditions in which people are born, grow, live, work, and age – what are known as the social determinants of health…
CMS has announced revisions to the ACO Realizing Equity, Access, and Community Health (ACO REACH) model to improve health equity and predictability for participants. Full Article
ACO REACH, which began its first model year in January, is a redesign of CMS’ controversial direct contracting model that’s meant to tie traditional payments in Medicare to value and improve care coordination. Regulators shelved the direct contracting program last year, after some progressives slammed the model as a thinly veiled effort to privatize the Medicare…
Health inequities in the United States are persistent and pervasive, resulting from well-documented discrimination inside and outside the health system. These inequities are both preventable and treatable. Reforming how we pay for care is one of the many tools the health system has to improve equity. Yet reform efforts have fallen short and have only recently begun to…
If CMS’s new proposed option for APP Reporting becomes part of the Final Rule, ACOs will have the ability to limit quality reporting to Medicare patients only. Your ACO must now determine whether reporting Medicare-only patients saves work and money and best demonstrates your quality. Use these Roji TIPS to decide what approach will work…
The goal of value-based care (VBC) is to create financial incentives for providers to improve patient outcomes while controlling costs of care. Unlike the traditional “fee for service” (FFS) model, under which providers are reimbursed based on volume, VBC rewards providers for efficiently delivering higher-quality care. While greater operational efficiency and cost control are essential…
Download Slides The healthcare industry is currently experiencing a paradigm shift. HCC Version 28 fundamentally changes how healthcare organizations adjust for risk, and organizations should begin the transition now to be ready for next year. Join experts from Lightbeam Health Solutions as they delve into the pivotal CMS HCC v28 model changes, outline the…
The United States is one of the most dangerous among wealthy nations for women to give birth. Disturbingly, it’s even more dangerous for women of color. Black women are about three times more likely to die from pregnancy-related complications than white women, while maternal mortality rates among American Indian and Alaska Native (AIAN) women are…
Download Slides Value-based care (VBC) organizations specialize in improving the quality of care while controlling costs. This risk-based model places an emphasis on delivering better patient health outcomes. Investment in VBC increased nearly 4X from 2019 to 2021. Last year CMS announced their goal to shift 100% of MA members to accountable care by…
Private equity is gaining a foothold in healthcare despite growing evidence that its role has been detrimental to care quality and prices. But new data and even governmental concern aren’t slowing private equity investments in provider organizations. Full Article