Wanted: Better Script For Health System And Medical Group Transition To APMs

May 18, 2022acoalternative payment models, APMs

Health care has been suffering for a while—just ask any participant, including patients. You will hear about burnout, pressures to perform, changes in the market, pressures of new technology, fiefdoms, consumerism, and to top it off, the buildup of competition between traditional health care enterprises and new corporate health care businesses. Then there’s the pandemic,…

Future of Value-Based Care, Role of Alternative Payment Models

April 14, 2022acoalternative payment models, APMs

François de Brantes is senior vice president of Episodes of Care at Signify Health and has been designing and implementing value-based payment programs for over a decade. For Signify Health, he leads customer development of Medicare Advantage, self-insured employer, and commercial payer markets. In this interview, Mr de Brantes discusses alternative payment models, advancing value-based…

Most health systems still base doctors’ pay on volume, despite push toward value-based care: study

January 28, 2022acoalternative payment models, APMs, fee-for-service, FFS, value-based care, value-based payment, vbc

Despite the growth in value-based payment arrangements from payers, health systems continue to pay physicians based on the volume of services they provide. A new study published in the journal JAMA Health Forum finds that volume-based compensation was the most common type of base pay for more than 80% of primary care physicians and for more…

The Perils and Payoffs of Alternative Payment Models for Community Health Centers

January 18, 2022acoalternative payment models, APMs

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. CMMI considers APMs to be any arrangements whereby providers are held accountable for the quality and costs of care,…

Hierarchical Payment Models—A Path for Coordinating Population- and Episode-Based Payment Models

January 14, 2022acoalternative payment models, APMs, Bundled Payments, CMS, value-based payment

In November 2021, the Centers for Medicare & Medicaid Services (CMS) announced a strategy to achieve near-universal participation in value-based payment models by 2030. Core to this strategy is the goal that every beneficiary should be in a clinical care relationship that has accountability for quality and total cost of care. Achieving this goal will…

Analytics Needed to Succeed in Alternative Payment Models

December 15, 2021acoalternative payment models, analytics, APMs, health data, healthcare data, patient data

Analytics and reporting tools can help providers that participate in Alternative Payment Models (APMs) measure the pulse of their program performance and provide helpful insights into their population health and risk levels, as well as uncover the potential for lowering cost and improving care quality. Generally speaking, APMs are structured such that providers are measured…

FLAACOS 2021 VBC PANEL SURVEY: A Summary of ACOExhibitHall.com Advisory Board Responses

December 2, 2021Garrett SchmittNo Commentsaccountable care, ACO, ACO infrastructure, ACOEH, advisory board, alternative payment models, APMs, CMMI, COVID-19, FLAACOs, Global and Professional Direct Contracting Model, Medicare Advantage, SDOH, social determinants of health, Survey, value-based care, value-based contracting, value-based infrastructure, vbc

On November 4, 2021, the Executive VP of the ACO ExhibitHall.com (ACOEH), John Schmitt, Ph.D., MBA, served as Panel Moderator of the FLAACOS 2021 Conference session titled “How to successfully transition from fee-for-service medicine to value-based care”. He was joined by Dr. Brent Staton, CEO of CCHI (ACO), as well as Rachel Corbitt, Executive Director,…

Stakeholders Seek to Drive Near 100% of Medicare Reimbursements to Value-Based Contracts by 2025

November 23, 2021Garrett SchmittNo Commentsalternative payment models, APMs, COVID-19, Medicare, Medicare reimbursements, value-based care, value-based contracts, value-based reimbursement, vbc

The U.S. federal deficit is the highest it has ever been. Healthcare makes up the largest portion of that deficit and the COVID-19 pandemic continues to amplify the issue. Over the past few years, the Centers for Medicare and Medicaid Services (CMS) has lead the charge towards value-based contracting, which “encourages providers to deliver the…

Health Systems Set Sights on Risk-Based Payment in Medicare Advantage

November 17, 2021Garrett SchmittNo Commentsalternative payment models, APMs, health systems, Healthcare Financial Management Association, HFMA, Medicare, Medicare Advantage, risk-based payment, value-based APMs, value-based reimbursement

Health systems are planning to advance their risk-based payment strategies by taking on more upside or downside risk, professional capitation, or global capitation in Medicare Advantage lines of business in 2022, according to a recent survey. The executive survey conducted by the Healthcare Financial Management Association (HFMA) for the Guidehouse Center for Health Insights found that…

The 2022 CMS PFS And QPP Final Rule: A Warning Shot To Provider Holdouts Of Value-Based APMs

November 10, 2021Garrett SchmittNo Comments2022 Physician Fee Schedule, alternative payment models, APMs, CMS, Medicare, Medicare Physician Fee Schedule, PFS, Physician Fee Schedule, value-based APMs, value-based care

CMS has released the 2022 Physician Fee Schedule and Quality Payment Program (QPP) Final Rule, and the message of these 2,414 pages is clear: CMS wants to push providers into value-based care arrangements. That intent was foreshadowed by the Proposed Rule released over the summer, which confirmed our predictions of trends under the Biden administration. Specifically, we saw a push…

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