Garrett Schmitt | VBCExhibitHall Library

Medicare Accountable Care Spending Patterns: Shifting Expenditures Associated With Savings

February 12, 2018Garrett SchmittNo Comments

The Medicare Shared Savings Program (MSSP) seeks to improve care quality while reducing unnecessary costs in traditional Medicare fee-for-service by adopting an accountable care organization (ACO) model. MSSP participants receive additional Medicare payments for delivering care below an established benchmark price and for meeting certain population-focused quality measures. As of early 2018, CMS reported 561…

Medicare ACOs – The Enrollment & The Savings Are Increasing

February 9, 2018Garrett SchmittNo Comments

Our team recently took a look at the Medicare ACO trends, and to us one thing was clear: executive teams of provider organizations should be thinking about the role that ACOs are playing in the market now more than ever. Why? Because the ACO financing model is becoming more dominant in the Medicare market-and becoming…

5 reasons why your EHR isn’t enough for success in value-based care

February 8, 2018Garrett SchmittNo CommentsTelehealth, Telemedicine

We recently convened a convention room full of leaders from independent physician practices nationwide and asked them if they believed value-based care was here to stay. Eighty percent said yes. With that in mind, we then asked them what was most likely to keep them up at night throughout 2018. Their top answer: transforming their…

The ABC of Physician Engagement: Point-of-Care Support For More Holistic Care

February 7, 2018Garrett SchmittNo CommentsPhysician Engagement, physician Satisfaction

In January 2015, the Department of Health and Human Services set a goal to tie 50% of the Medicare payments to value or quality by 2018. This transition has put physicians on the frontlines of healthcare, as they play a major role in the value-based roadmap of an organization. However, on the downside, this shift…

The downside risk cliff: What the 82 ACOs about to be forced into downside risk should do right now

February 2, 2018Garrett SchmittNo CommentsDownside Risk, Next Generation, Risk

With last month’s addition of 17 new organizations to the Next Generation ACO program, 26% of all Medicare ACOs now participate in a downside-risk model (including the Medicare Shared Savings Program’s (MSSP) Track 1+, Track 2, and Track 3), up from 17% in 2017. While 2018 is shaping up to be a big year for…

CMS proposes 1.84% rate increase for Medicare Advantage plans, other policy changes

February 2, 2018Garrett SchmittNo CommentsCMS, Medicare Advantage

The federal government on Thursday proposed a 1.84% average rate increase for Medicare Advantage plans in 2019, along with other policy tweaks that officials said are designed to strengthen the MA and Medicare Part D programs. The rate increase is a good deal higher than the 0.45% increase the agency approved for 2018. However, it…

The Road From Volume-To-Value: The Pivotal Role of Population Health

January 29, 2018Garrett SchmittNo CommentsPopulation Health

Two macro trends are converging to further season and ultimately catalyze the transformation of the American healthcare enterprise: the predominant fee-for-service model that fuels the provider ecosystem (hospitals, health systems, medical groups, IPAs, ACOs, or managed physician networks, etc.) and their ‘partner’ financing plans, payors or administrators. Ecosystem incumbents include national or regional commercial health insurers…

Leveraging social determinants of health data for value-based care success

January 22, 2018Garrett SchmittNo CommentsPopulation Health, Predictive Modeling, social determinants

To achieve quality health outcomes, organizations must deliver excellent patient care. However, patients may suffer poor outcomes – even if they have access to the best care in the world – if providers fail to consider social determinants of health, including factors such as socioeconomic status, education, social network support, access to care, access to…

Payer, Provider Collaboration Required for Accountable Care Success

December 28, 2017Garrett SchmittNo CommentsCollaboration, Payers

The accountable care organization (ACO) movement has gained traction over the last year as payers and providers begin to share the same viewpoints on the benefits of value-based care. Provider attitudes about ACOs and related value-based care models are generally positive as more providers are looking to enter into these agreements. Payers have reported successful…

High-Value Culture, Population Health Programs Key to ACO Success

December 5, 2017Garrett SchmittNo Comments

Creating a high-value culture, engaging in proactive population health management, and implementing an infrastructure that promotes continuous performance improvement were key characteristics of 11 successful accountable care organizations (ACOs) studied by the Health Care Transformation Task Force. The Task Force examined the ACOs in Medicare programs and at least one commercial contract to find scalable…