PCPs | Value-based care news, articles, webinars and materials

Small primary care practices that received training in quality measures to enhance care improved patient outcomes

November 9, 2021Garrett SchmittNo Commentsenhanced care, patient outcomes, PCPs, Primary Care, primary care practices, quality measures, training

A team of family medicine researchers conducted an assessment to determine if the implementation of policies and workflows designed to improve quality of care in smaller primary care practices was associated with improved health outcomes for patients with cardiovascular disease. The study also examined whether enhancements in quality improvement capacity are associated with a change…

Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2: Building On The ACO Model

September 30, 2021Garrett SchmittNo Commentsdirect contracting, Medicare, Medicare Advantage, MSOs, PCPs, Risk, SPACs

Given an Orwellian title, Direct Contracting, launched by Center for Medicare and Medicaid Innovation (CMMI), was anything but direct. “Indirect Contracting” would have been a far more accurate name, since the cornerstone of the program was CMS’s opening the door to non-provider-controlled “Direct Contracting Entities (DCEs)” to become the fiscal intermediaries between patients and providers….

Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 1: The Risk-Score Game

September 29, 2021Garrett SchmittNo Commentsdirect contracting, Medicare, Medicare Advantage, MSOs, PCPs, Risk, SPACs

While the COVID-19 pandemic rages, the past two years have seen another epidemic of a far different type—in financing and acquisitions of firms focused on serving Medicare beneficiaries. These firms include physician practices, notably primary care practices (PCPs); management services organizations (MSOs) that aggregate practices; and Medicare Advantage (MA) insurers. In this arena, the combined…

New ACO Playbook: Three Ultimate ACO Strategies To Keep Physician Practices Onboard

August 19, 2021Garrett SchmittNo CommentsACO, ACOs, consolidation, Medicare, PCPs, physician participation, physician practice, physicians, Primary Care, value-based care, value-based payment, value-based payment models, vbc

ACOs have zealously protected their favored status under Medicare Value-Based payment models, ensuring enough time for organizations to feel comfortable with financial risk and make investments in infrastructure. But if your own ACO is losing physicians to new equity-financed networks or to hospitals consolidating practices, more time does not help you. Primary care physicians are…

Hybrid Primary Care Payment Structure Crucial to Quality Care

August 12, 2021Garrett SchmittNo Commentshybrid reimbursement model, PCPs, value-based care, value-based payments, vbc

High quality, patient-centered care requires a hybrid primary care payment system that encourages value-based care and physician quality assurance, according to an opinion article published recently in JAMA. Researchers responded to a recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM), titled “Implementing High-Quality Primary Care.” The NASEM report depicted a fragile primary care structure in the US…

FLASH INTERVIEW — Stellar Health

July 30, 2021Garrett SchmittNo CommentsACO, ACOs, flash interview, incentive program, PCP, PCPs, primary care providers, stellar, stellar health, value-based care, vbc

Stellar Health partners with both payors and Accountable Care Organizations to develop a tailored incentive program to reward the completion of granular value-based care actions by primary care providers. The Stellar Health Platform includes the web-based Stellar Application, which delivers a simple checklist of recommended clinical actions to practices based on each patient’s medical…

Telemedicine Use Higher Among PCPs with Value-Based Payment

July 16, 2021Garrett SchmittNo CommentsPCPs, Primary Care, Telehealth, Telemedicine, value-based care, value-based payment, vbc

Telemedicine use skyrocketed among primary care practices during the pandemic, specifically for those with a value-based payment model, according to a research letter published in JAMA Health Forum. Many patients were forced to delay primary care due to the pandemic, which resulted in significant revenue losses for primary care organizations. Telemedicine use naturally increased to make up for lost revenue…

Healthcare Payment Reform is Critical to Improving Primary Care

May 18, 2021Garrett SchmittNo CommentsPayers, payment reform, PCPs, Primary Care, value-based care, value-based payment, value-based reimbursement, vbc

High-quality primary care implementation requires significant healthcare payment reform, expanded telehealth capabilities, and team-based care, according to a recent report from the National Academies of Sciences, Engineering, and Medicine. According to the report, 85 deaths per day are associated with the declining workforce in primary care. Compensation in primary care is typically lower than that of specialty…

Why PCPs Should Focus on Coding and Documentation in Value-Based Care Programs

May 12, 2021Garrett SchmittNo CommentsCoding, documentation, PCPs, risk adjustment, vbc

Each year, a growing number of providers are entering value-based care arrangements, including primary care providers (PCPs). Given their holistic view of patients, PCPs are the best types of clinicians to drive value-based care. Medicare’s Primary Care Transformation programs and many payer-developed value-based care contracts are proof of the move for PCPs to be at…

Do accountable care organizations differ according to physician-hospital integration?

March 26, 2021Garrett SchmittNo CommentsIDS, PCPs, physician-hospital integration, Primary Care

Physician-hospital integration among accountable care organizations (ACOs) has raised concern over impacts on prices and spending. However, characteristics of ACOs with greater integration between physicians and hospitals are unknown. We examined whether ACOs systematically differ by physician-hospital integration among 16 commercial ACOs operating in Massachusetts. Using claims data linked to information on physician affiliation, we…