Payers may be prepared to comply with the interoperability rule for the July 1 deadline, but are they ready to adopt healthcare interoperability long-term? For the past couple of years, CMS has pushed the industry to take bigger steps toward standardizing interoperability. “CMS continues to build on its roadmap to improve interoperability and health information…
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…
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…
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…
Healthcare costs and low-value care tend to increase when hospitals acquire physicians, new studies published in Health Affairs show. The number of diagnostic and lab tests performed in hospitals versus unaffiliated facilities increased after doctors were acquired by hospitals, which inflated healthcare costs, according to an analysis of 30 million imaging procedures and 341 million…
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…
A group of leading healthcare industry groups are calling on HHS to provide more full-risk accountable care organization (ACO) model options, including an extension of the popular Next Generation ACO Model. “We are writing to urge HHS to extend this model through 2022 and create a permanent full risk ACO option based on Next Gen…
Fourteen healthcare organizations wrote a letter to HHS urging it to extend the Next Generation Accountable Care Organization model through 2022 instead of letting it expire at the end of 2021. The groups also urged HHS to establish a permanent full-risk ACO option based on the Next Generation Accountable Care Organization model. Full Article
Newly confirmed Health and Human Services Secretary Xavier Becerra needs to reverse a slide in participation among accountable care organizations, the National Association of ACOs (NAACOS) said. The advocacy group wrote in a letter to Becerra on Monday that HHS should also set a national goal to have the majority of Medicare beneficiaries within an ACO…
Accountable care organization (ACO) participation in the Medicare Shared Savings Program has hit a new low in 2021, according to new data from CMS. The data dropped by CMS this week showed that 477 ACOs are participating in Medicare’s flagship ACO program in 2021, down from 517 ACOs in 2020. The ACO participation number is…