One major challenge in the U.S. has been that healthcare funding and incentives have not included resources to address the social causes of health inequities. This has perpetuated the problem. Conversely, several European countries have combined funding for health and social services and created incentives for communities and organizations to address both areas collectively. Over…
By 2025, accountable care organizations will be required to do quality reporting via electronic clinical quality measures (eCQMs). Maria Alexander, senior director of population health at Mount Sinai Health System in New York, recently spoke about the pros and cons of reporting via eCQMs during the voluntary transition period between now and then. The Centers…
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…
The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus the…
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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…
Despite incredible work by health care workers during the pandemic, consumer and patient trust and belief in the health care system is dangerously low. Why is this a big problem now? Because as pressure to implement Value-Based Care initiatives is intensifying and creating more financial pressure on your already-slim margins, your health system or ACO…
One way health systems have tried to improve patient outcomes has been the creation of Accountable Care Organizations (ACOs), partnerships among care providers that offer a unified combination of services. But what happens when these ACOs aren’t able to provide all the services necessary for a patient’s entire continuum of care? New research by Aravind…
On the heels of several years of declining or flat accountable care organization (ACO) growth in the Medicare Shared Savings Program (MSSP), 2022 only saw a modest increase in participation, with 483 ACOs partaking. The current numbers do not bode well in terms of meeting the Biden administration’s goal of having every traditional Medicare patient…
The Centers for Medicare & Medicaid Services (CMS) has announced that 11 million patients with Medicare will be treated by Shared Savings Program Accountable Care Organizations (ACOs) in 2022. According to a news release, the announcement came as part of the agency’s annual summary of the Medicare Shared Saving Program; Medicare’s national ACO program. “With…