Humana Healthcare Research has released new data showing that Medicare Advantage patients with heart failure who are treated by value-based care (VBC) physicians are significantly more likely to receive recommended therapies than those in traditional care models. According to Humana’s Value-Based Care Issue Brief, patients in VBC arrangements were nearly 28% more likely to receive full quadruple therapy —…
The American Hospital Association (AHA) has launched its Health Equity Roadmap, a resource to support hospitals and health systems. The road map consists of three parts: an equity transformation assessment, a customized action plan and a virtual community of peers. The resource is meant to meet providers where they are in their equity journey, the…
Virtual platforms democratized scientific meetings during the COVID-19 pandemic but, as any meeting-goer will tell you, it’s the questions from the floor and the back-and-forth of an expert panel that often reveal the importance of and/or problems with a presentation. It’s the scrutiny that makes the science resonate, especially in this postfactual era. The all-virtual…
Healthcare costs and low-value care tend to increase when hospitals acquire physicians, new studies published in Health Affairs show. The number of diagnostic and lab tests performed in hospitals versus unaffiliated facilities increased after doctors were acquired by hospitals, which inflated healthcare costs, according to an analysis of 30 million imaging procedures and 341 million…
Fourteen healthcare organizations wrote a letter to HHS urging it to extend the Next Generation Accountable Care Organization model through 2022 instead of letting it expire at the end of 2021. The groups also urged HHS to establish a permanent full-risk ACO option based on the Next Generation Accountable Care Organization model. Full Article
A flurry of recent mandates will completely upend the negotiating table between payers and providers, but how the final contracts will change going forward all depend on enforcement. Although most negotiations between hospital systems and insurers have been finalized for 2021, Rick Kes, a senior analyst at RSM, said recent mandates around surprise billing, price…
A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment Models (APMs) in 2021. The survey from the National Association of ACOs (NAACOS) recently found that more than 90 percent of ACOs participating in an Advanced APM, including the Medicare Shared…
CMS issued a proposed rule Aug. 9 that would make sweeping changes to the Medicare Shared Savings Program, including overhauling the way ACOs share in risks and rewards. Here are seven things to know about the proposed rule: 1. The redesigned program — which CMS has dubbed “Pathways to Success” — would expand ACO participation…
An avalanche of new pay proposals from the CMS seeks to reduce provider burden, so much so that it could undermine efforts to shift Medicare to a value-based system, doctors warned. The agency released a 1,400-page proposed rule July 12 that for the first time combined the annual physician fee schedule and the Medicare Quality…