CMS targets reforms to benchmarks to kick-start flat ACO participation

April 28, 2022acoACO, ACOs, MSSP

The Biden administration wants to change how benchmark payments to accountable care organizations are calculated to make it easier for providers in the Medicare Shared Savings Program (MSSP) to qualify for savings. Leaders in the Centers for Medicare & Medicaid Services (CMS) outlined several changes they are pursuing to get more providers involved in value-based…

FLASH INTERVIEW — CareSignal — March 2022

March 3, 2022acoNo CommentsACO, ACOs, data integration, health data, health tech, health technology, healthcare data, Interoperability, normalization, remote monitoring, remote patient monitoring, RPM, Telehealth, transactional data, transactional health data, value-based care, vbc

 Remote monitoring for value-based care organizations. CareSignal Deviceless RPM is accessible, scalable, and cost-effective. Visit the CareSignal Exhibit Booth

CMS overhauls Direct Contracting model to include new requirements on governance, health equity in 2023

February 24, 2022acoACO, ACOs, direct contracting

The Biden administration is redesigning the controversial Direct Contracting Model to add new requirements to tackle health equity and ease progressive lawmakers’ concerns over the role of private equity. The Centers for Medicare & Medicaid Services (CMS) announced Thursday that the professional and global Direct Contracting Model will transition in 2023 to the Accountable Care…

ACO Groups Disappointed With Results for Medicare ‘Shared Savings’ Program

February 1, 2022acoACO, ACOs, CMS, Medicare, Medicare Shared Savings Program, MSSP

Are 66 new accountable care organizations (ACOs) in a year a sign of progress or a disappointing result? That depends on who you ask. CMS announced last week that 66 additional ACOs joined the Medicare Shared Savings Program (MSSP) for ACOs in 2022, bringing the total up to 483 ACOs. However, that number is only…

ACO Investment Model Produced Savings, But The Majority Of Participants Exited When Faced With Downside Risk

January 27, 2022acoACO, ACOs

Medicare’s Accountable Care Organization (ACO) Investment Model (AIM) provided up-front funding to forty-one small, rurally located ACOs to encourage their participation in the Medicare Shared Savings Program. We estimate net savings to Medicare of $381.5 million over three years, driven by utilization reductions in inpatient and other institutional care and by the absence of shared…

The Case For ACOs: Why Payment Reform Remains Necessary

January 24, 2022acoACO, ACOs, FFS, GPDC, value-based care, vbc

Medicare population-based payment models, broadly known as accountable care organization (ACO) models, of which the Global and Professional Direct Contracting Model (GPDC) is an example, were launched out of recognition of two largely inherent weaknesses of fee-for-service: FFS does not promote efficiency, nor does it promote equity. The Centers for Medicare and Medicaid Services (CMS)…

How to Avoid an ACO Exodus — or Having No Takers in the First Place

January 24, 2022acoACO, ACOs, Downside Risk, Risk, risk management

The question of whether ACOs should be forced to accept “downside risk” — in effect pay a penalty if they exceed certain spending benchmarks — has bedeviled CMS’ ACO programs and ACO programs in general. Seema Verma, the Trump administration’s CMS director, pushed for more downside risk, and the administration’s Pathway to Success program shortened…

Growth in Health Information Exchange With ACO Market Penetration

January 17, 2022acoACO, ACOs, care coordination, health information exchange, HIE, Hospitals, Interoperability

Accountable care organization (ACO) success depends in part on a broad network of health information exchange (HIE) partners to effectively coordinate care. Our study illustrates that although ACO participation broadens HIE networks, the effects accrue differently across markets with varying levels of ACO penetration. ACO hospitals in high–ACO penetration markets increase their HIE network breadth…

CMS Officials’ Bold Statement of Intent Around Health Equity and Value-Based Care

January 14, 2022acoACO, ACOs, CMS, health equity, SDOH, social determinants, social determinants of health, value-based care, vbc

As we reported on Wednesday, Jan. 12, “The top officials at the federal Centers for Medicare and Medicaid Services (CMS) on Tuesday, Jan. 11, made a major public statement regarding the goal of moving the healthcare system towards health equity, and a major component of that statement focused on leveraging Medicare’s value-based programs, particularly those…

Integra ACO To Launch Home Care Programs Using Advanced Remote Monitoring Technology

January 6, 2022acoaccountable care, accountable care organizations, ACO, ACOs

Yet another benefit of the pandemic’s telehealth expansion is more hospital-at-home (HAH) and remote patient monitoring (RPM) programs. Integra Community Care Network, the accountable care organization (ACO) for Care New England Health System, is launching both in partnership with tech company Biofourmis. And with the Centers for Medicare & Medicaid Services (CMS) expanding HAH waiver…

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