ABSTRACT Objectives: The number of commercial beneficiaries cared for by accountable care organizations (ACOs) is growing, but the literature examining their trends is nascent. Study Design: We examined commercial claims data from 2019 to 2021 to compare beneficiaries attributed to participants in Medicare Shared Savings Program ACOs with and without a major teaching hospital. Methods:…
On June 26, the Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Transforming Maternal Health (TMaH) Model. TMaH is ten-year delivery and payment model designed to test whether effective implementation of evidence‑informed interventions, sustained by a value-based payment (VBP) model, can improve maternal outcomes and reduce Medicaid…
Amid rapid health care industry consolidation, a challenging cost environment, and increasing patient needs and expectations, only truly nimble health care organizations will survive and thrive. Medical groups focused on prepaid, value-based care are better positioned to innovate, develop, and invest in technologies to respond to patient needs and market dynamics. For example, value-based organizations…
Healthcare providers are continuing to form and invest in Accountable Care Organizations (ACOs) as a means of improving care quality and reducing costs. Some of the largest ACOs serve upwards of hundreds of thousands of patients, while, overall, 13.7 million Medicare beneficiaries are being cared for by ACOs this year, according to the Centers for…
As opportunities to provide palliative care through Accountable Care Organization (ACO) relationships continue to arise, operators will likely need to understand the varying types of reimbursement that exist in that arena. ACOs are groups of physicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients….
With the high costs of care in oncology, value-based care is extremely important, but the transition is challenging when providers are still being paid by fee for service, too, explained Lalan Wilfong, MD, senior vice president, value-based care, Thyme Care. Full Article
Better relationships between payers and providers will be key to developing successful value-based initiatives that benefit patients while addressing the concerns of both stakeholders, according to panelists at the Community Oncology Alliance (COA) Payer Exchange Summit. The panel discussion highlighted the ongoing challenges and opportunities for payers and providers to collaborate on innovative, data-driven value-based…
Forty years ago, at the height of the AIDS epidemic, HIV researchers and physicians discovered that simply treating the symptoms of the disease was not enough to provide lasting improvement for patients. Other factors like unstable living conditions, drug use, the public stigma over AIDS and HIV – known today as social determinants of health…
For ACOs to remain relevant as leaders of Value-Based payment models, they must step up now to generate more cost savings for Medicare patient care. Budget cuts for Medicare are once again under discussion by conservatives as political pressure mounts to lower governmental spending. Meanwhile, CMS is expanding risk in Medicare value-based payment models, moving…
Institutional Special Needs Plans could be the tool nursing homes need to find better clinical and financial success and help the government achieve its goals of reducing costs and improving quality, a trio of researchers and policy advisors argues in the New England Journal of Medicine. But more data is needed to determine whether the…