What’s New: The CMS Innovation Center released the third annual evaluation report and early results ahead of the fourth report for ACO REACH that shows the model improved healthcare quality and reduced gross spending during its first four performance years. Why it Matters: This latest evaluation of ACO REACH provides strong evidence that accountable care organizations (ACOs)…
Medicare’s unprecedented and unpredictable spending growth in recent years is penalizing clinicians who have been most effective at slowing cost growth and improving care. The Accountable Care Prospective Trend (ACPT) in the Medicare Shared Savings Program (MSSP) could cost accountable care clinicians more than $700 million in lost shared savings for care delivered in 2025….
Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is “empowering consumers with the…
Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is to “empowering consumers with the necessary…
No matter how large or well-resourced a health system may be, making the right care decisions ultimately depends on its ability to exchange information with healthcare’s “digital have-nots”—organizations that weren’t eligible for EHR implementation incentives, like post-acute facilities, home health, substance use disorder clinics and assisted living facilities. When these technology connections don’t exist, this…
The Medicare Shared Savings Program (MSSP) is the largest value based care program from the Center for Medicare & Medicaid Services (CMS) to date. Since its inception in 2012, Accountable Care Organization (ACO) participation has doubled; providing care to over 10 million beneficiaries, generating $1.94 billion in total savings, and earning over $1.47 billion in…
Download Slides Over 30 million US citizens are members of an ACO. While ACOs have strong incentives to adopt advance care planning (ACP) for long-term success, one out of five ACOs have few or no end-of-life processes in place. Although ACP can be difficult to coordinate across various care settings, there are processes that…
It was my first bereavement group meeting. One after another, people recounted heart-wrenching tales full of tears, anger, regret and loneliness over the loss of their spouse. Their partners had died in hospitals, with medical personnel trying to work miracles right up to the bitter end. They did not feel good about their spouses’ medical…