In January 2016, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS) launched the Next Generation Accountable Care Organization (NGACO) model. This advanced alternative payment model (AAPM) builds on previous CMS accountable care organization (ACO) initiatives in the Medicare program. NGACOs comprise groups of practitioners and institutions…
A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment Models (APMs) in 2021. The survey from the National Association of ACOs (NAACOS) recently found that more than 90 percent of ACOs participating in an Advanced APM, including the Medicare Shared…
Although research has shown that a person’s health outcome is closely related to the social and environmental backgrounds they live and interact with, questions around how social factors impact health outcomes have never received copious attention until the country was struck by the COVID-19 pandemic. Data released by the Center for Diseases Control and Prevention…
As if things weren’t dramatic enough already in U.S. healthcare, a “battle of the narratives” has developed between senior officials at the Centers for Medicare & Medicaid Services (CMS), especially CMS Administrator Seema Verma, and the leaders of NAACOS— the National Association of ACOs—which have been locked in an ongoing war of words with each…
Key Insights Accountable care organizations (ACOs) in the Centers for Medicare and Medicaid Services’ (CMS) Pathways to Success Program saved $1.2 billion in healthcare costs in 2019. The results show how physicians have been able to reduce wasteful healthcare spending while improving patient outcomes throughout the COVID-19 pandemic. Physicians can get involved with an ACO…
CMS has issued a letter to Medicaid directors regarding how states can accelerate their Medicaid value-based care adoption, based largely on lessons learned in CMS efforts toward value-based care in Medicare. “The Trump Administration has long worked to accelerate the overdue move to value-based care, but for too long these efforts have been piecemeal,” said CMS Administrator…
Many providers are concerned about rising thresholds in Medicare ACOs, which could lead them to reconsider participation in value-based models, according to a new survey. The National Association of Accountable Care Organizations (NAACOs) surveyed 116 ACOs across a number of programs, and found that 90% were concerned they would be unable to reach qualifying thresholds in…
The federally appointed Physician-Focused Payment Model Technical Advisory Committee said Tuesday it has recommended HHS consider a payment model focused on asthma care. The payment model, if approved by HHS, would provide allergists, immunologists and pulmonologists a value-based payment option. A longstanding complaint of the movement to alternative payment models is it has excluded many specialists from…
COVID-19 has highlighted why access to timely and actionable public health data is critical for making quick, life-saving healthcare decisions. Which patient population segments are at a higher risk of mortality and which of these are getting needed preventive services? What regions in the country are flash points for COVID-19 resurgence? Are the Providers…
Over the last three years, under the Trump Administration, the Centers for Medicare & Medicaid Services (CMS) has been advancing innovative payment and service delivery models to help move our health care system from one that pays for volume to one that rewards providers for keeping patients healthy, improving health outcomes and lowering costs. A…