Social determinants of health (SDOH) are associated with increased Medicare spending per beneficiary in certain geographic areas, according to a study from the Journal of the American Medical Association. Addressing social determinants of health in these regions can potentially lead to reduced healthcare spending and better quality healthcare. The results show that Medicare spending was higher in geographic locations where…
Accountable care organization (ACO) growth has hit a snag again, with the COVID-19 pandemic impacting the number of ACOs in public and private contracts, according to a new analysis. The analysis published in the Health Affairs blog found that ACO growth has plateaued over the last couple of years, starting in 2019 when CMS introduced…
To advance value-based care, the Medicare Payment Advisory Commission (MedPAC) has suggested that HHS reduce its number of alternative payment models (APMs) now that it has lessons learned from a wide range of previous demonstrations. “Operating a smaller portfolio of more harmonized models, with more consistent parameters and clearer and more aligned incentives, should more…
Two influential advisory groups sent recommendations to Congress calling for a revamp of how health plans are paid in the lucrative Medicare Advantage program, culling how many models CMS tests and curbing high-cost drug approvals. By many measures, the MA program has been thriving. Enrollment and participation has continued to grow, and in 2021, MA…
To reduce redundancies and confusion in the Medicare system, health care policymakers should consider implementing “a smaller, more harmonized” portfolio of alternative payment models (APMs). That’s according to the Medicare Payment Advisory Commission (MedPAC), which released its regular June report to Congress on Tuesday. “In many cases, providers participate in multiple [alternative payment models] simultaneously,…
A group of bipartisan lawmakers wants the Center for Medicare and Medicaid Innovation (CMMI) to be more transparent in its handling of value-based care models as the center continues a major overhaul of its demonstrations. The 24 lawmakers sent a letter to CMMI Director Liz Fowler on Wednesday seeking for more insight into the center’s…
The Biden administration is exploring making more payment models mandatory in the future as it implements a more patient-centric vision for value-based care. Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler detailed parts of this vision on Thursday during an interview with Health Affairs Editor-in-Chief Alan Weil. Fowler said voluntary models come with major…
The move to value-based care—where payment for volume of services is being supplanted by payment for outcomes of care—has proceeded with remarkable speed since the Affordable Care Act (ACA) went into law a mere ten years ago. Payment for outcomes increasingly focuses on holding providers of healthcare responsible for total costs of care. Accountable Care…
Dive Brief: The Biden administration has paused or pulled some models testing value-based payments in healthcare, but the new director of the CMS agency overseeing model testing said the slowdown doesn’t equate to waning motivation for its mission. Elizabeth Fowler, who took the reins at the Center for Medicare and Medicaid Innovation a few months ago, said…
The healthcare system is at a critical point in its transition to value-based care a decade after implementation of the Affordable Care Act and its Center for Medicare and Medicaid Innovation (CMMI), according to CMMI’s newly minted director Liz Fowler, PhD, JD. “The goal [of the ACA] was to create a system that rewards better…