Skilled nursing providers are facing an extremely challenging operating environment, but they must keep adapting and innovating as the shift toward value-based care continues across the U.S. health care system. And in fact, providers have tremendous opportunities to seize. “Value-based care through the population health management model is the most exciting thing I’ve had the…
The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits to significantly impact the shift to value-based care. The CY 2023 PFS proposed rule included changes to the Medicare Shared…
The CMS outlined potential guidance last week on issues like healthcare equity and climate change in its final inpatient payment rule as the federal government heightens its healthcare oversight on social issues. In the report, the CMS released comments that it received after soliciting public input during its proposed rule in April. The feedback on…
While the Centers for Medicare & Medicaid Services (CMS) proposes to make some of the most significant changes to its accountable care organization (ACO) model since it was finalized in 2011, it doesn’t appear that such updates will have a lasting impact on the broader skilled nursing industry. If anything, only operators with their own…
The American Medical Association has criticized the new Medicare payment schedule proposed rule released last week by the Centers for Medicare and Medicaid Services, saying it fails to account for inflation in practice costs and “COVID-19-related challenges to practice sustainability.” The proposed 2023 Physician Fee Schedule (PFS) conversion factor is $33.08, a decrease of $1.53…
CMS just set off summer fireworks, amping up incentives to adopt Value-Based Care in its just-released, 2,066-page 2023 Proposed Physician Fee Schedule Rule. By encouraging formation of new ACOs, the Proposed Rule establishes a pathway to expand beneficiaries’ access to accountable care. Last year, CMS committed that every Medicare beneficiary will be in an accountable…
The CMS is proposing an overhaul of the Medicare accountable care organization program in an effort to improve equity. The plan, which includes efforts to get more providers into ACOs and particularly ramp up rural participation, was applauded by ACO groups. The changes for ACOs in the Medicare Shared Savings Program would give some organizations more…
Created upon enactment of the Affordable Care Act (ACA) in 2010, the Center for Medicare & Medicaid Innovation (CMS Innovation Center) was established to design, implement and test new healthcare payment and delivery models for Medicare and Medicaid. Managed by the Centers for Medicare & Medicaid Services (CMS), the CMS Innovation Center aims to achieve…
Download Slides In today’s value-based care landscape, growth and success may appear different for each organization. Market conditions, resources and budgets, company goals – each of these play a role in determining the go-to-market strategy. To truly understand and define these areas, you need to first start by looking at your performance insights. …
In recent years, momentum among Accountable Care Organizations (ACOs) to improve health equity has increased. The Centers for Medicare & Medicaid Services’ announcement of the redesigned ACO REACH contracting model to improve health equity will only accelerate this momentum. In this blog, we will help ACOs and healthcare payers understand how healthcare analytics can be used to identify health equity challenges…