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…
Roughly 40% of U.S. healthcare payments were tied to alternative payment models (APMs) last year, with Medicare Advantage claims representing the largest amount, a new survey found. The survey, published Wednesday by the Health Care Payment Learning & Action Network, showed that more work needs to be done as most healthcare payments were still tied…
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,…
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 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…
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…
The Next Generation Accountable Care Organization (ACO) Model has saved Medicare millions of dollars over the past four performance years. But with one more year to go due to the COVID-19 pandemic, the Model is actually operating at a loss. Next Generation ACOs have saved Medicare nearly $667 million thanks to reductions in Parts A…
Medicaid will be an increasing focus of alternative payment models (APMs) from the Center for Medicare & Medicaid Innovation (CMMI), Ellen Lukens, MPH, said Wednesday at the annual Population Health Colloquium hosted by Thomas Jefferson University. “Models have been predominantly Medicare-oriented, and have disproportionately served white beneficiaries,” said Lukens, who is policy and programs group…
The Biden administration wants to move away from creating value-based care payment models for every type of disease, episode of care or specialty groups to streamline its projects, a top official said. Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler said during a briefing Tuesday hosted by the Alliance for Health Policy that more…
As we reported in a news article on Sept. 30, “A dispute has arisen over controversial statements made by two prominent healthcare policy leaders around the Medicare Advantage program. On Sept. 30, Donald Berwick, M.D., and Richard Gilfillan, M.D., published an article in the Health Affairs Blog entitled “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2:…