DOWNLOAD SLIDES The CDC reports that 6 in 10 adults in the US have a chronic disease and 4 in 10 have two or more. With the prevalence of chronic diseases in mind, it’s no surprise that they are the leading driver for the nation’s $3.8 trillion in annual healthcare costs, and the diabetic population…
For South Texas Physician’s Alliance, social determinants of health referral has been a learning experience. The organization, which has joined providers across the country in efforts to address social determinants of health, knew the best solution was connecting patients to social services providers. A patient presenting with food insecurity needs a referral to a food…
Is it possible for disparities between population cohorts to be overcome or neutralized through technology? I believe the answer is yes. Over the past year, COVID-19 has magnified the gaps in healthcare on a large scale. We see this in higher rates of the virus in people of color, through the access or lack thereof…
Keeping within expenditure limits is a top priority for most ACOs for Medicare. That makes sense. Savings are the main distinguishing feature of an ACO arrangement, as opposed to straight Fee-for-Service reimbursement. ACOs that accept downside risk can’t afford to exceed the expenditure target. It’s in their best interest to create initiatives to cut costs…
Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure noted higher participation in value-based payment models like Institutional Special Needs Plans (I-SNPs) during a recent discussion with HealthAffairs, but also hinted that consolidation of such programs may be needed. “Too many models in too many places that aren’t coordinated with each other,” is how Brooks-LaSure…
Accountable care organizations (ACOs) were understandably disappointed in mid-May when the Centers for Medicare and Medicaid Services (CMS) announced that its Next Generation ACO Model would not be extended into 2022. Launched in 2016, the CMS model provides experienced ACOs with a way to assume higher financial risks and rewards offered through the Medicare Shared…
Alma Trotter published an important whitepaper this week that highlights the importance of CMS’ role as an operator in addition to health industry regulator on enabling patient digital access to their health information. As a passionate supporter of the CARIN Alliance (whose mantra for consumers is “access to more data, with less friction”), I’ve celebrated Ciitizen’s Patient Record Scorecard and in…
The Certified Community Behavioral Health Clinic (CCBHC) model has been shown to reduce hospitalizations, cut costs and improve employee recruitment and retention for participants. And on top of all that, it can also help set providers up for success in value-based care models. “CCBHC funds can really help organizations put those building blocks into place…
Partnering with private consulting firms could prompt hospitals to participate in a greater number of episodes in a federal bundled payments program, according to new research. The voluntary Bundled Payments for Care Improvement initiative Advanced Model, or BPCI Advanced, compares spending for specific clinical episodes, like congestive heart failure or sepsis, with benchmarks set by the Centers…
ACOs have zealously protected their favored status under Medicare Value-Based payment models, ensuring enough time for organizations to feel comfortable with financial risk and make investments in infrastructure. But if your own ACO is losing physicians to new equity-financed networks or to hospitals consolidating practices, more time does not help you. Primary care physicians are…