With debate on “repeal and replace” in the rearview mirror, new leadership at the Department of Health and Human Services (HHS), and the threat of rising health care spending undermining economic growth, policy makers are contemplating new models and incentives to speed providers toward value-based care and alternative payment models (APMs). The policy underpinning this…
Medicare accountable care organizations (ACOs) operating under two-sided financial risk arrangements save the federal healthcare program more than one-sided risk organizations. But policymakers must address financial incentives, benchmarks, and other issues to ensure two-sided risk ACOs continue to generate savings, the Medicare Payment Advisory Commission (MedPAC) recently reported. “Medicare ACOs were created to help moderate…
As a part of the medical industry’s overall shift toward more value-based care, healthcare professionals are focusing on driving patient wellness. For payers, this means implementing wellness programs to promote healthy behavior change among beneficiaries. According to Healthcare.gov, a wellness program is: A program intended to improve and promote health and fitness that’s usually offered…
Download Slides This is Part 2 of a two part series and was recorded on 6/19/2018. As with Part 1, this webinar will be informative for those considering taking risk in an ACO, specifically Track 1 ACOs considering moving to a risk-based model in 2019. What was covered in this session: The standoff between…
Healthcare organizations are stepping up to the plate when it comes to older adult care and chronic care management, according to a recent report from BDO Center for Healthcare Excellence & Innovation. The report, which was informed by an NEJM Catalyst survey, found that healthcare organizations are looking into home health services, strong chronic disease…
Value-based care has resulted in medical cost savings, investments from commercial lines of business and an accelerated decline in fee-for-service, according to a Change Healthcare national research study. The study, conducted by ORC International in April and commissioned by Change Healthcare, included a survey of 120 managed Medicare, managed Medicaid and commercially focused payers. Here…
Payers that implemented value-based payment models reduced healthcare costs by an average of 5.6 percent, improved provider collaboration, and created more impactful member engagement, according to a new study from Change Healthcare. The Finding the Value: The State of Value-Based Care in 2018 report, presented at the 2018 AHIP Expo, found that payers are effectively…
There are now more than 335 Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in 47 states, DC, and Puerto Rico. Early results show that most Medicare ACOs are succeeding at meeting their quality benchmarks, but only about a quarter of MSSP participants have been able to reduce their spending enough…
Medicaid payments are increasingly becoming state budget busters as the program covers frequent emergency room admissions and outpatient tests, according to Kaiser Health News. Here are four things to know about why some states are turning to Medicaid ACOs to alleviate financial load: 1. Minnesota is one of the states that has implemented an ACO…
The United States healthcare system is experiencing a major shift in delivery and payment policy to address out-of-control spending and low-quality care. In 2010, the Affordable Care Act (ACA) set in motion a new vision for healthcare delivery and reimbursement—value-based care—aimed at replacing the “broken” traditional fee-for-service (FFS) model. Massive change takes time, yet lawmakers…