There was nary a session at the annual conference of America’s Health Insurance Plans that did not include a mention social determinants of health. Whether it was from the stage or on the show floor, there was widespread acknowledgement that these determinants are crucial factors in achieving the best health of a wide variety of…
Participants in the CMS’ advanced bundled payment model will soon be able to apply the benefits of the program to all beneficiaries part of the Medicare Shared Savings Program. In an email on Friday, the CMS said beginning Jan. 1, healthcare providers participating in model year 3 of the Bundled Payments for Care Improvement Advanced…
Providers are gearing up to participating in risk-based alternative payment models through commercial payers and Medicare, according to a new Navigant analysis based on a survey conducted by the Healthcare Financial Management Association (HFMA). Seventy-two percent of the 170 hospital and health system senior finance executives surveyed reported that their organizations will have the capabilities to adopt…
Finance executives at hospitals and health systems see the most opportunity to work with commercial insurers to increase downside risk in payment contracts, according to a new survey. The survey, published Wednesday by consultancy Navigant, found 64% of finance leaders said they plan to assume additional risk in contracts with commercial payers in the next…
Accountable Care Organizations (ACOs) may not be as effective as many believe when it comes to reducing healthcare costs and improving outcomes, according to a new study. The study, published in Annals of Internal Medicine, examines data from ACOs participating in the Medicare Shared Savings Program (MSSP). It finds that savings and quality improvements previously attributed to the design of…
Beneficiaries who participate inconsistently in Accountable Care Organizations (ACO) under the Medicare Shared Savings Program (MSSP) have much higher healthcare costs than do beneficiaries who never participated in an ACO to begin with, according to a report released Friday afternoon by the Medicare Payment Advisory Commission (MedPAC). Beneficiaries who participated in the same ACO consistently year after…
Americans’ use of telehealth has grown rapidly in recent years, but there is still ample room for the technology to scale up as consumers increasingly demand convenient access to healthcare. Between 2015 and 2019, the size of the U.S. telehealth services market has more than doubled to $2.3 billion, according to estimates from IbisWorld. Currently, 76%…
While alternative payment models such as ACOs aim to improve quality while lowering cost, 86 percent of U.S. physicians are still reimbursed in a fee-for-service model. This is a disincentive to engage in preventive care and reduce readmissions on a global scale. During an executive roundtable hosted by Change Healthcare at the Becker’s 2nd Health IT…
How can federal healthcare officials effectively stimulate forward the Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs)? A team of healthcare policy researchers believes that senior officials at the Centers for Medicare and Medicaid Services (CMS) will need to rethink the financial incentives for ACO leaders—and will need to face up to a…
Download Slides As provider organizations prepare for Pathways to Success and determine their best approaches for aligning with CMS’s accelerated risk path, ACO’s have important decisions to make in order to ensure their success under CMS’s value-based initiatives, including how to: – Determine the right performance track and when to select it – Find…