Value-based care continues to take root in healthcare. It’s clear the future of reimbursement will at minimum include a heaping portion of providers being paid for value as opposed to volume. This is why, as the new year approaches, Healthcare IT News sat down with an expert in value-based care to get his views on…
Recently, the Center for Medicare and Medicaid Innovation (CMMI) introduced their strategic refresh “Putting All Patients at the Center of Care” to support broader, more equitable, and outcome-based healthcare delivery transformation while streamlining current and future payment models. Since its inception in 2010 as a part of the Affordable Care Act, CMS has launched over 50 innovation/pilot…
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…
Recently, The Centers for Medicare and Medicaid Services (CMS) released a proposal for it’s 2022 Physician Fee Schedule. Over the last several years, more non-traditional modalities of healthcare have found their way into the CMS reimbursement landscape. This is promising as it suggests that CMS is aligning themselves with consumer demand and technology developments by…
The Guidehouse Center for Health Insights has just released analysis of an executive survey in conjunction with HFMA, the 2021 Risk-Based Healthcare Market Trends, that found health systems appear to be going big into risk sharing in 2022, with these percentages of respondents planning to advance into upside/downside risk sharing, professional capitation or global capitation for:…
The federal agency responsible for developing new health care payment models wants every fee-for-service Medicare beneficiary to be getting care from a provider who’s part of an accountable care organization by 2030. That goal is laid out in a recent white paper from the Center for Medicare and Medicaid Innovation (CMMI), “Driving Health System Transformation—A Strategy for the CMS Innovation Center’s Second Decade.”…
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…
The year of 2020 was dominated by the news of how COVID-19 spread around the world, and how life has been changed by the disruption of this pandemic. We have witnessed the journeys of battling the disease, dedication and sacrifices by the front-line heroes, and the emotional roller coaster of wondering when this pandemic would…
The Medicare Shared Savings Program, the accountable care organization (ACO) model that served 10.6 million seniors in 2020, collectively saved Medicare $4.1 billion last year, and $1.9 billion after accounting for shared savings payments, according to the National Association of ACOs and as recently published in Healthcare Finance. 513 ACOs participated in the Shared Savings Program in 2020, down…
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…