At the beginning of this series, we laid out a basic tenet: As shared savings plan ACOs, you need to do as well or better at lowering costs than competing value-based payment models. Otherwise, your resources and support will dwindle in favor of more promising avenues to control Medicare spending, and competition will stifle your…
The Biden administration wants to move away from creating value-based care payment models for every type of disease, episode of care or specialty groups to streamline its projects, a top official said. Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler said during a briefing Tuesday hosted by the Alliance for Health Policy that more…
COVID-19 pandemic fatigue has many people seeking a return to normalcy. But health care needs a new normal—one that achieves better health outcomes for more people. Wishing for a return to health care’s old normal is like driving into a long tunnel hoping for a U-turn that takes you back to where you started. Multiple…
HealthEC offers a KLAS-recognized, end-to-end population health management platform designed to help ACOs succeed with value-based care. Our HealthEC CareConnect® generates personalized, clinically-proven plans that enable teams, including community-based resources, to deliver patient-centric care. Advisory services are also available to guide our ACO partners in defining their strategic goals as they transition from volume…
As we reported in a news article on Sept. 30, “A dispute has arisen over controversial statements made by two prominent healthcare policy leaders around the Medicare Advantage program. On Sept. 30, Donald Berwick, M.D., and Richard Gilfillan, M.D., published an article in the Health Affairs Blog entitled “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2:…
The concept of holistic, or whole person, care continues to gain traction as the best way to address the healthcare sector’s overall mission of improved health outcomes, lower costs and improved patient experiences. Understanding the role of social determinants of health (SDOH) has become a primary focus for providers, payers, consumers and government agencies because…
Accountable care organizations (ACOs) can improve health equity in their patient populations, but they need more funding and flexibility to do so, according to a report from a group representing 370 ACOs. “ACOs are already beginning to do the work of addressing negative [social determinants of health] to improve quality and control costs for the…
Accountable care organizations (ACOs) participating in the Medicare Shared Savings Program had a record performance year in 2020. The ACOs saved Medicare $4.1 billion while achieving an average quality score of 97.8 percent. One of the health systems participating in the program—Advocate Aurora Health—led the nation in savings and quality. Advocate Aurora’s affiliated ACOs generated $110 million in…
On Oct. 1, at the NAACOS Fall 2021 Conference, executives from three accountable care organizations described the daunting road ahead in transitioning to the submission of electronic clinical quality measures (eCQMs) to the Centers for Medicare & Medicaid Services. After receiving strong feedback from ACOs about how challenging (and expensive) the transition to eCQMS would…
Given an Orwellian title, Direct Contracting, launched by Center for Medicare and Medicaid Innovation (CMMI), was anything but direct. “Indirect Contracting” would have been a far more accurate name, since the cornerstone of the program was CMS’s opening the door to non-provider-controlled “Direct Contracting Entities (DCEs)” to become the fiscal intermediaries between patients and providers….