Launched in 2017 to reward high-value clinicians with upward reimbursement adjustments and penalize low-value clinicians with downward adjustments, the nationwide Medicare Quality Payment Program (QPP) consists of two potential participation tracks: the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM). In recent posts, we detailed how strong performance in the MIPS…
While value-based care models have made great strides toward breaking down silos, coordinating care, and better serving patients, it is time to take steps further. In order to make value-based care truly beneficial to patients, those very patients have to be at the center of care, according to experts presenting at Xtelligent Healthcare Media’s third…
Alternative payment models have been en vogue in American healthcare for some time now. Payers and providers are increasingly being asked to take on greater financial risk instead of shared savings alone. The latest data out this week shows that 34% of total U.S. healthcare payments were tied to APMs in 2017, up 12% from two…
Value-BASED payment models require physicians to deliver the best outcomes while managing resources appropriately. Physicians have long focused on quality of care, but in a relatively new development, they now have to pay attention to resource utilization as well, with the goal of reducing overall cost of care. To succeed at this, they need data…
A bipartisan group of nine lawmakers today sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma asking for two key changes to the agency’s recently proposed rule that would reform the Medicare Shared Savings Program (MSSP). Specifically, the lawmakers asked that CMS reconsider proposals to cut the time new…
By 2020, a projected 68 million people will be enrolled in an accountable care organization (ACO), a care model in which groups of doctors, hospitals, and other health care providers work together to coordinate care for patients. While ACOs seek to address rising health care costs and inconsistent quality of care, evidence of savings achieved…
Comments have closed on the proposed CMS rule to overhaul the Medicare Shared Savings Program (MSSP), a controversial plan that would force accountable care organizations (ACOs) to take on more financial risk sooner than originally scheduled. This is a critical moment for CMS, as the agency now faces the question of how hard and how…
Accountable care organizations have experienced a change of heart and say they will likely stay in the Medicare Shared Savings Program even if that means taking on downside financial risk sooner, according to an association survey released Tuesday. Nearly 50% of the ACOs surveyed by the National Association of ACOs said they would participate in…
Many payers, most notably the Centers for Medicare and Medicaid Services (CMS), have developed new payment models that base reimbursement on a broader bundle of services than traditional fee-for-service payment. The accountable care organization (ACO) program exemplifies the broadest of these new payment models. One of the crucial ACO design features is the extent to…
Although patient-provider communication is an essential aspect of the primary care visit, expectations aren’t quite reality, according to data from Samueli Integrative Health Programs, a non-profit healthcare advocacy group. A survey of 2,000 adult patients conducted online by Harris Poll revealed that patients want to discuss more than their physical health during a primary care…