The reason CMS Alternative Payment Models (APMs) are failing to significantly reduce spending in Medicare is that none of the major APMs meets the majority of the eight criteria for a successful APM. The Problems with Medicare’s Alternative Payment Models and How to Fix Them details the serious weaknesses in the six major Advanced APMs that have…
CMS just announced the 2019 ACO application deadlines for new and renewing ACOs. The dates are extremely aggressive: Notice of Intent to Apply (NOIA) is due on Friday, January 18th at 12:00 p.m. EST Applications are due on or before February 19, 2019 For 2019, CMS is only offering a July 1, 2019 off cycle…
Until recently, efforts to improve the health of Americans have focused on expanding access to quality medical care. Yet there is a growing recognition that medical care alone cannot address what actually makes us sick. Increasing health care costs and worsening life expectancy are the results of a frayed social safety net, economic and housing…
Over two-thirds of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) would qualify as high-revenue organizations under the new Pathways to Success initiative, a recent Leavitt Partners analysis uncovered. Pathways to Success will overhaul and replace the MSSP in July 2019. “As ACOs consider entering the MSSP under the new Pathways rule, they must recognize the…
Medicare Advantage insurers added 1.4 million members to their rosters for 2019 coverage, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But Advantage membership is growing at slower pace compared with previous years. According to the latest federal data showing enrollment as of this month, 22.4…
Hospitals that have implemented value-based payment models are more likely to adopt technologies for population health, care coordination, data management and analytics, according to Deloitte’s “Beyond the EHR” report. For the report, researchers from professional services firm Deloitte analyzed data from 4,500 U.S. hospitals between 2012 and 2016. The analysis centered on two key questions: 1. “Were…
Accountable care organizations seeking to participate in the overhauled Medicare Shared Savings Program should expect a shorter period of time to begin to reap savings through their efforts to better manage their patient populations before the Centers for Medicare & Medicaid Services expects them to shoulder more risk. So they’d better plan accordingly, according to…
If you want to understand the shifting sands of healthcare, you’ll find no better place than the nonprofit provider track during the infamous JP Morgan Healthcare Conference that took place this week in San Francisco. Over 40,000 players were in town from every corner of the healthcare ecosystem. However, if you want to hear the…
What might be in the works over at the Centers for Medicare and Medicaid Innovation (CMMI)? Are there new pilot models actively in development that will be rolled out this year? Many industry stakeholders, including federal lawmakers, are eager to know what the relatively opaque agency has in store. Created under the Obama administration, CMMI…
Many health systems seem to be waiting for the tide to shift to value-based care before adopting technology that will support new payment models. But waiting to invest could put health care organizations at risk of falling behind. Executive summary WHAT kinds of technology are health systems investing in, and do investments vary depending on whether…