The majority of physicians now participate in an accountable care organization (ACO), the American Medical Association (AMA) recently reported. Overall, 53.8 percent of physicians polled in September 2018 for the AMA’s Physician Practice Benchmark Survey reported participating in at least one ACO type that year. The percentage is up from 44.0 percent in 2016, the recently…
CMS Administrator Seema Verma on Tuesday told insurers that they need to support the Trump administration’s policies on transparency, value-based payments, interoperability and data access, cautioning them that the health insurance industry is under threat from disgruntled patients, doctors and politicians. Speaking at the America’s Health Insurance Plans’ 2019 National Conference on Medicare, Verma said…
Imagine the future when you go to your doctor to be treated for some sort of ailment. After collecting and entering key data into an app, she’s presented with a clinical diagnosis and optimal course of treatment, including the correct medications. While she’s there to talk “human-to-human” to the patient, it’s a predictive model and…
Healthcare leaders charged with implementing population health management programs view the value-based care initiative as a tectonic shift in how healthcare will be delivered in the years to come. Their biggest struggle? Convincing providers that their efforts signify more than an unnecessarily complex administrative endeavor. Many administrators struggle to get physicians to discuss transitioning to…
About 90,000 clinicians who participated in advanced alternative payment models in 2017 are concerned that they haven’t received bonuses from the CMS. Advanced alternative payment models, also known as advanced APMs, were created under MACRA in 2015 and offer an opportunity for clinicians to receive a 5% bonus to their Medicare payments if they participate….
Why do readmissions continue to plague hospitals? There’s one primary reason: It’s very difficult to control patients’ behavior once they are discharged. For example, hospitals cannot control whether patients take medications as prescribed, follow-up with providers and comply with other discharge instructions. This is a huge challenge for hospitals trying to reduce readmissions for conditions…
The latest accountable care organization (ACO) participation numbers for the Medicare Shared Savings Program (MSSP) raise concerns for the National Association of ACOs (NAACOS). In a recent Health Affairs blog post, the leading ACO group reported that, in 2019, the MSSP experienced a dip in ACO participation for the first time since the program launched…
Accountable care organizations participating in the Medicare Shared Savings Program have generated $1 billion in savings since their inception—leading the way in value-based care, according to a new report from data activation platform company, Innovaccer. For its report, titled, “State of the Union Report for Medicare ACOs,” Innovaccer used its proprietary algorithm to look at…
A patient’s racial or ethnic background could influence which emergency department (ED) an ambulance takes her to, causing a considerable hit on health disparities and health equity, according to new data published in JAMA Open Network. Health disparities, or inequities in patients’ abilities to achieve health or unequal disease burden, impact patients across the country. Depending on certain social…
In mid-July, the Centers for Medicare and Medicaid Services (CMS) released the latest number of accountable care organizations (ACOs) participating in the Medicare Shared Savings Program. This was the first opportunity for ACOs to apply to participate in CMS’s largest value-based payment program since the agency redesigned the program last year. Changes CMS calls “Pathways to Success”…