NAACOS, APG Urge HHS to Adjust Direct Contracting Model, Not Cancel

February 16, 2022acoAMA, APMs, CMMI, congress, DCEs, direct contracting, FFS, HHS, NAACOS

More than 200 healthcare organizations, including America’s Physician Groups (APG) and the National Association of ACOs (NAACOS), have urged the Department of Health and Human Services (HHS) to make adjustments to the Global and Professional Direct Contracting Model instead of canceling the program. In a letter to HHS Secretary Xavier Becerra, the groups stressed that shutting down the Direct…

Healthcare Groups Plead with HHS’ Becerra to Retain Direct Contracting Model

February 15, 2022acoBecerra, DCEs, direct contracting, HHS

A large group of 222 healthcare organizations, both national healthcare associations and provider organizations, including accountable care organizations (ACOs), sent a letter on Monday, February 14, to Health and Human Services Secretary Xavier Becerra, urging him not to cancel the Global and Professional Direct Contracting (GPDC) model, but instead make adjustments to it. Among the…

Becerra: Health Equity, Justice Remain “North Star” for HHS

February 9, 2022acoBecerra, COVID-19, COVID-19 vaccine, health equity, HHS, pandemic, SDOH

After nearly a year of health equity work, Department of Health & Human Services (HHS) Secretary Xavier Becerra said the department will continue to make justice in the medical space a top priority. “Dr. King famously called injustice in health the most inhumane and shocking form of inequality,” Becerra began in a keynote address during…

Over 50 Lawmakers Urge Administration to End Direct Contracting

January 17, 2022acoAMA, APMs, CMMI, congress, DCEs, direct contracting, FFS, HHS, NAACOS

The lawmakers claim direct contracting is a Trump-era privatization tactic that has removed millions of seniors from Traditional Medicare without their knowledge or consent. More than 50 lawmakers led by US Representative Pramila Jayapa urged the Biden administration to discontinue the Medicare Direct Contracting (DC) program and transition Medicare beneficiaries into the Traditional Medicare model. In a letter written to HHS…

Expanding Social Determinants of Health Benefits Among Public Payers

October 11, 2021Garrett SchmittNo CommentsBipartisan Policy Center, HHS, Medicaid, Payers, preventive care, public payers, SDOH, social determinants of health

HHS needs to expand the list of social determinants of health that public payers can cover and hold public payers accountable to covering preventive services that can help address social determinants of health, the Bipartisan Policy Center said in a report. “The U.S. can improve population health and health outcomes by integrating social services with the…

ACOs Angling for a Bigger Role in Health Equity

October 4, 2021Garrett SchmittNo Commentsaccountable care, ACO, ACOs, CMS, health equity, HHS, Medicare, NAACOS, Population Health, Primary Care, primary care centers, SDOH, Social Services

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…

HHS aims to use value-based care payment models to lower drug prices

September 9, 2021Garrett SchmittNo CommentsCMMI, drug prices, HHS, Pharmaceuticals

The Department of Health and Human Services wants to test models that would pay drugs based on their clinical value as part of a new plan to tackle high prices. The plan released Thursday lays out several administrative tools the agency plans to take to address high prices. It also calls on Congress to adopt several reforms…

Increase in Medicare Advantage Activity to Address Social Determinants of Health, But Barriers Still Remain

August 5, 2021Garrett SchmittNo CommentsCMS, HHS, Medicaid, Medicare Advantage, SDOH, social determinants of health, social needs, Star Ratings, Value-Based Insurance Design, VBID

As Medicare Advantage continues to serve a proportionally higher-risk and more diverse enrollment population, a new report highlights innovative approaches to addressing social determinants of health (SDOH) for Medicare Advantage beneficiaries, while acknowledging barriers that remain. Social determinants of health are non-medical factors that account for up to 55% of an individual’s health outcomes, according…

The Little-Known Agency That’s Trying To Boil The Ocean—A Look At CMMI’s Decade Of Trying To Change Medicare & Medicaid

July 26, 2021Garrett SchmittNo CommentsACA, CMMI, CMS, HHS, Medicare

When asked about government’s influence and impact on healthcare, I like to cite my friend, former Health and Human Services (HHS) Secretary Michael Leavitt, who says, “If you want to change healthcare you have to change Medicare.” Everybody else—the commercial insurers and the providers—will follow. But changing Medicare is hard. As we’ve seen, even with…

Consensus among HHS agencies on addressing social determinants of Health Through Better Data Capture, Interoperability

July 15, 2021Garrett SchmittNo CommentsAmerican Rescue Plan, Data, data capture, Federal Health IT Strategic Plan, HHS, Interoperability, Notice of Proposed Rulemaking, NPRM, OCR, ONC, SDOH, United States Core Data for Interoperability, USCDI, USCDI version 2

Over the last decade, members of the medical and public health communities around the world have widely studied and acknowledged the impact of social determinants of health (SDOH)—the conditions in the environments where people live, learn, work, play, and age—on a wide range of health, functioning, and quality-of-life-risks and outcomes.[1] In the past year or…

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