People living in rural America have lower incomes, less education, and are in poorer health than those living in other areas of the United States. For more than a century, these measures have been “sticky” with little change despite many efforts to do so. It is also well-known that most rural areas have a shortage of primary care and specialist physicians and lack of…
When the Centers for Medicare and Medicaid Services (CMS) have announced the 2020 results for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in early September, Intermountain Healthcare’s Castell Accountable Care organization was revealed to have received a quality score of 97.03 percent and to have generated $11.5 million in savings for Medicare. The…
In August, Administrator Chiquita Brooks-LaSure and other leaders from CMS shared their priorities for the next 10 years. In particular, they called out the importance of reducing inequities in health care, striving to get all Medicare and Medicaid beneficiaries in accountable care relationships, and designing financial incentives that will encourage participation in new payment and…
Z codes, which are ICD-10-CM codes used to identify non-medical factors that may affect a patient’s health status, are a useful way to track social determinants of health and capture standardized data for Medicare beneficiaries. However, they are underused, with Z codes reported from only 1.59 percent of beneficiaries in 2019, according to a new…
Amid the difficulties of the last year, a bright spot has emerged that may provide a strong indication of renewed movement toward the transformation of the healthcare industry that we know today. Value-based care, a model that rewards better patient health outcomes, has experienced a surge in interest amid heightened consumer awareness and among payers seeking to lower costs…
Despite claiming to have prioritized health equity, the Biden administration just missed an opportunity to address poor nutrition—an important health and equity issue for older adults in particular. When the Centers for Medicare and Medicaid Services (CMS) recently released its FY 2022 Hospital Inpatient Prospective Payment System Final Rule, something was conspicuously absent from the Hospital…
Accountable care organizations (ACOs) can improve health equity in their patient populations, but they need more funding and flexibility to do so, according to a report from a group representing 370 ACOs. “ACOs are already beginning to do the work of addressing negative [social determinants of health] to improve quality and control costs for the…
The Biden administration needs to provide money upfront to help form accountable care organizations in rural areas and give more financial support to address health equity, a new report finds. The National Association of ACOs (NAACOS) released a white paper Wednesday that outlines a series of recommendations to better position organizations to help address health…
The Medicare Shared Savings Program (MSSP) is the largest value-based care program from the Center for Medicare & Medicaid Services (CMS) to date. As of 2020, there were 513 ACOs participating in the program, with a total shared savings of $2.28 billion.8 This program seeks to accomplish the following: Promote accountability among healthcare institutions for the…
CMS is looking to modernize the ACO reporting process by mandating the use of electronic clinical quality measures (eCQMs). However, accountable care organizations (ACOs) are concerned that the lack of healthcare interoperability will make electronic ACO reporting near impossible. “CMS must avoid making eCQMs mandatory until standard data fields exist across EHRs, and true interoperability…