The Role of CINs in Securing Value-Based Contracts

August 18, 2021Garrett SchmittNo CommentsACOs, CINs, Clinical Integration, Clinically Integrated Networks, cost savings, value-based care, value-based contracts, vbc

It was recently calculated the United States spends $3.8 trillion – or 18 percent of the national economy – on healthcare. The current healthcare landscape indicates this spending rate will not slow anytime soon due to the COVID-19 pandemic, an ongoing healthcare crisis. Value-based care models like Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs) have…

The role of CINs in securing Value-Based Contracts

August 18, 2021Garrett SchmittNo CommentsACO, ACOs, CIN, CINs, Clinical Integration, value-based care, value-based care contracts, vbc

It was recently calculated the United States spends $3.8 trillion — or 18 percent of the national economy — on healthcare. The current healthcare landscape indicates this spending rate will not slow anytime soon due to the COVID-19 pandemic, an ongoing healthcare crisis. Value-based care models like Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs) have…

A New Elephant is in the ACO Waiting Room: It is Following the Money

August 18, 2021Garrett SchmittNo CommentsACO, ACO savings, ACOs, Medicare

Several years ago in the early days of Accountable Care Organizations (ACOs), we worried and warned about the importance of how each organization should divide up potential savings. In a white paper published in Physician Leadership Journal and on the Salient Web site, co-author Stephen Sheiko and I called it an “Elephant in the ACO…

ACO Participation May Keep SNFs ‘In the Game’

August 8, 2021Garrett SchmittNo Commentsaccountable care, accountable care organizations, ACOs, skilled nursing facilities, SNFs

Although accountable care organizations (ACOs) have never been particularly popular among skilled nursing facilities, timing may be ripe to take on more risk to stay competitive in the market. ACO participation may help operators maintain referrals when so many potential residents are being diverted to home health care, hospice and other tracks along the continuum…

Medicaid Authorities and Options to Address Social Determinants of Health (SDOH)

August 5, 2021Garrett SchmittNo CommentsACOs, CMS, COVID-19, Medicaid, SDOH, social determinants, social determinants of health

Extensive research and the pandemic have elevated the importance of addressing social determinants of health (SDOH) to improve health and reduce longstanding disparities in health and health care.1 Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Prior…

FLASH INTERVIEW — Stellar Health

July 30, 2021Garrett SchmittNo CommentsACO, ACOs, flash interview, incentive program, PCP, PCPs, primary care providers, stellar, stellar health, value-based care, vbc

 Stellar Health partners with both payors and Accountable Care Organizations to develop a tailored incentive program to reward the completion of granular value-based care actions by primary care providers. The Stellar Health Platform includes the web-based Stellar Application, which delivers a simple checklist of recommended clinical actions to practices based on each patient’s medical…

Five Important Health Care Trends That Consumers Should Track

July 29, 2021Garrett SchmittNo CommentsACO, ACOs, consumers, cost transparency, coverage, health care trends, health costs, health inequities, health literacy, healthcare, healthcare costs, healthcare trends, Informed Patient, patient health data, SDOH, value-based care, vbc

In the world of health care, change is never-ending. Politics, government regulation, scientific advancement, technology, and the economics and financing of health care foster shifts to reshape how care is delivered and how much it costs. Many of these shifts are completely invisible to us as health care consumers. But they also drive what is…

3 Strategies To Push ACO Savings Beyond Coordination of Care Limits

July 25, 2021Garrett SchmittNo CommentsACOs, care coordination, coordination of care, savings

Will accountable care organizations (ACOs) be the value-based payment model of the future?That depends. As the value-based care market has changed, ACO numbers have dropped and competitive payment models have attracted medical groups. ACOs need to prove that the shared savings model can increase historical savings and retain provider participation. And they may have limited…

Value-Centric Legislation Gives ACOs a Leg Up

July 22, 2021Garrett SchmittNo CommentsACOs, APMs, legislation, news, vbc

Members of the U.S. House of Representatives this week introduced bipartisan legislation to strengthen Medicare’s value-based care models and accountable care organizations (ACOs), among other alternative payment models (APMs). Doctors, hospitals and other providers make up an ACO — the group coordinates care for Medicare patients while limiting extraneous services and preventing medical errors. The better…

The (SGR) Fix Is In: How MACRA Short-Circuited Incentives For Joining Two-Sided Models

July 21, 2021Garrett SchmittNo CommentsA-APMs, ACOs, Advanced Alternative Payment Models, alternative payment models, APMs, CMS, delivery system reform, delivery systems, healthcare payment, incentives, MACRA, Medicare Access and CHIP Reauthorization Act, MIPS, payment systems, SGR

Over the last ten years, policymakers of both parties have identified health care payment reform as a critical national priority. Payment incentives offered by Medicare and other large payers create the environment in which providers must choose between being rewarded for performing more services and procedures, as in fee-for-service medicine or, for efficiently managing the…

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