As 2023 dawns, strategic conversations in health care are shifting away from the pandemic’s “crisis mode” to refocus on addressing long-term needs and opportunities to improve patient outcomes. Patient engagement is an area that is consistently discussed as ripe for evolution. In an ideal world, every health care provider would be focused on patient engagement…
The Biden administration rolled out three new payment models intended to lower drug costs, including new Medicare coverage options for drugs cleared under accelerated approval. The release of the three models on Tuesday is in response to an executive order President Biden delivered last year calling for the federal government to search for ways to…
To advance its goal of having 100% of people in traditional Medicare in an accountable care relationship in seven years, the Centers for Medicare and Medicaid Services has announced three initiatives in the Medicare Shared Savings Program and the ACO REACH and Kidney Care Choices models. More than 700,000 healthcare providers and organizations will participate…
The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits to significantly impact the shift to value-based care. The CY 2023 PFS proposed rule included changes to the Medicare Shared…
The CMS is proposing an overhaul of the Medicare accountable care organization program in an effort to improve equity. The plan, which includes efforts to get more providers into ACOs and particularly ramp up rural participation, was applauded by ACO groups. The changes for ACOs in the Medicare Shared Savings Program would give some organizations more…
April marked the 10-year anniversary of the start of the agreement period for the first Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) – an ambitious program to reward health care providers for improving health care for people with Medicare. The program now includes 483 ACOs with over 525,000 participating…
The Biden administration wants to change how benchmark payments to accountable care organizations are calculated to make it easier for providers in the Medicare Shared Savings Program (MSSP) to qualify for savings. Leaders in the Centers for Medicare & Medicaid Services (CMS) outlined several changes they are pursuing to get more providers involved in value-based…
On the heels of several years of declining or flat accountable care organization (ACO) growth in the Medicare Shared Savings Program (MSSP), 2022 only saw a modest increase in participation, with 483 ACOs partaking. The current numbers do not bode well in terms of meeting the Biden administration’s goal of having every traditional Medicare patient…
The Centers for Medicare & Medicaid Services (CMS) has announced that 11 million patients with Medicare will be treated by Shared Savings Program Accountable Care Organizations (ACOs) in 2022. According to a news release, the announcement came as part of the agency’s annual summary of the Medicare Shared Saving Program; Medicare’s national ACO program. “With…
For 10 years, the agency that runs Medicare has offered doctors and their practices extra money if they joined groups called Accountable Care Organizations and improved the quality of care they provided to older patients covered by traditional Medicare, while also focusing on the cost of their care. But a new study finds that those…