Two physician healthcare policy leaders are offering an examination of the value-based delivery and payment movement in healthcare from a health equity perspective, and have concluded that, while healthcare reimbursement reform can provide one element in moving the needle on health equity, it alone cannot provide a vehicle that will transform the U.S. healthcare system…
The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits to significantly impact the shift to value-based care. The CY 2023 PFS proposed rule included changes to the Medicare Shared…
Download Slides ACO REACH participants face a number of new challenges starting January 1, 2023. CMS will require every participating ACO to have a health equity plan in place to successfully identify, engage, and intervene with socially vulnerable populations. Organizations will be measured and evaluated based on their ability to execute this health equity…
Providers and payers are increasingly addressing the health-related social needs (HRSNs) of their patients to improve outcomes, reduce costs, and address health disparities. As this practice takes hold in the field, the landmark Accountable Health Communities (AHC) Model test that launched in 2017 has now ended. AHC was the Centers for Medicare and Medicaid Services’…
Download Slides August 1 marks the beginning of the CMS ACO REACH model implementation period, gearing up for the first performance year beginning January 1, 2023. Whether your organization is participating or not, the drive to incorporate SDOH to improve quality of care and outcomes is an initiative that will make its way to…
While the Centers for Medicare & Medicaid Services (CMS) proposes to make some of the most significant changes to its accountable care organization (ACO) model since it was finalized in 2011, it doesn’t appear that such updates will have a lasting impact on the broader skilled nursing industry. If anything, only operators with their own…
CMS just set off summer fireworks, amping up incentives to adopt Value-Based Care in its just-released, 2,066-page 2023 Proposed Physician Fee Schedule Rule. By encouraging formation of new ACOs, the Proposed Rule establishes a pathway to expand beneficiaries’ access to accountable care. Last year, CMS committed that every Medicare beneficiary will be in an accountable…
The CMS is proposing an overhaul of the Medicare accountable care organization program in an effort to improve equity. The plan, which includes efforts to get more providers into ACOs and particularly ramp up rural participation, was applauded by ACO groups. The changes for ACOs in the Medicare Shared Savings Program would give some organizations more…
A trio of publications from the Centers for Medicare and Medicaid Services (CMS) leadership this year has clarified and advanced the federal strategic vision for value-based care. In January, leaders reinforced their commitment to value-based care with the goal that “100 percent of people with Original Medicare will be in a care relationship with accountability…
Download Slides For many value-based care providers, one of the biggest obstacles is often the 10% to 20% of your population who make up your most “challenging” chronic patients. Treating and managing those chronic conditions is no mystery. The problem is getting your unengaged patients to better understand and take control of their…