Industry expert David Smith, Founder and CEO of Third Horizon Strategies, provides an overview of CMS’s value-based initiatives with specific perspectives on the new administration’s Medicare/Medicaid philosophy, the rise of complex care management, and Medicaid Advanced Payment Models. He also shares an update on the core CMS payment models including MIPS, ACOs, and BPCI, as…
Earlier this month, Premier hosted a panel on value-based care (VBC), with providers from across the healthcare continuum discussing its merits and pitfalls. In attendance were members of Congress and their staffers to hear how precisely VBC has been effective and policy changes needed to continue its forward progress. One message came through above all…
Researchers at the University of Pennsylvania recently published a white paper that proposes a roadmap for value-based care over the next decade. On March 12, the co-authors gathered virtually to discuss lessons learned over the last decade and their five key recommendations, which include aligning alternative payment models (APMs) across all publicly financed healthcare and giving health equity a…
Everyone who’s reeling from 2020 is hoping for light in 2021. Health care, especially—systems, hospitals, clinical practices and their providers—wants the pain to stop. What might lie ahead for health care next year? Here’s what we’re thinking about the near future, and what you should watch for in 2021. 1. Health care providers will be…
Everyone who’s reeling from 2020 is hoping for light in 2021. Health care, especially—systems, hospitals, clinical practices and their providers—wants the pain to stop. What might lie ahead for health care next year? Here’s what we’re thinking about the near future, and what you should watch for in 2021. 1. Health care providers will be…
Implementation of accountable care organizations (ACOs) has been occurring unevenly across the nation, with rural areas lagging behind their more urban counterparts in ACO establishment (for example, see here, here, and here). To help establish ACOs in more areas of the country, the Centers for Medicare and Medicaid Services (CMS) developed the ACO Investment Model (AIM) to provide participating ACOs…
Citing the ongoing COVID-19 public health emergency, 10 leading healthcare organizations are urging CMS not to move forward with changes to how accountable care organizations and other alternative payment models are assessed on quality in the Medicare Shared Savings Program and the merit-based incentive payment system. The proposed changes are in the 2021 proposed physician fee schedule….
A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment Models (APMs) in 2021. The survey from the National Association of ACOs (NAACOS) recently found that more than 90 percent of ACOs participating in an Advanced APM, including the Medicare Shared…
Dive Brief: Clinicians who were affiliated with a health system had “significantly better” performance scores under the Merit-based Incentive Payment System than those who were unaffiliated, according to a JAMA study published Tuesday. The researchers noted, however, that the study does not determine whether affiliated physicians were providing better quality care, raising questions about the program’s…
Recently CMS released the proposed rule for the 2021 Quality Payment Program (QPP), which covers both the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). For MIPS, there was speculation leading up to the release of the rule about how the COVID-19 pandemic would impact the program for 2020 and 2021. A thorough analysis…