Physician Advocates for Equity See Built-In Problems in ACO Incentives

August 16, 2022acoACOs, health equity, physicians

Two physician healthcare policy leaders are offering an examination of the value-based delivery and payment movement in healthcare from a health equity perspective, and have concluded that, while healthcare reimbursement reform can provide one element in moving the needle on health equity, it alone cannot provide a vehicle that will transform the U.S. healthcare system…

How physicians can untangle the web of relationships essential for value-based care success

June 3, 2022aconetworking, physicians

Primary care physicians (PCPs) and other physicians continue to migrate away from the traditional fee-for-service (FFS) reimbursement model toward value-based and risk-bearing care models that reward better outcomes and reduced healthcare costs. Value-based care (VBC) contracts are projected by McKinsey to cover nearly 65 million Americans, or 22% of insured lives, by 2025, up from…

How to Use Healthcare Analytics to Improve Care Access

May 4, 2022acoCMMI, CMS, Physician Engagement, physicians, SDOH

In recent years, momentum among Accountable Care Organizations (ACOs) to improve health equity has increased. The Centers for Medicare & Medicaid Services’ announcement of the redesigned ACO REACH contracting model to improve health equity will only accelerate this momentum. In this blog, we will help ACOs and healthcare payers understand how healthcare analytics can be used to identify health equity challenges…

How to Evaluate Physician Performance Using Appropriateness

March 30, 2022acoCMMI, CMS, Physician Engagement, physicians, SDOH

Appropriate Care: What’s the big deal? It is well known that the United States spends more than any other nation on healthcare, but as a nation, our health outcomes miss the mark. As evidence-based medicine evolves, it is important that our healthcare practices adapt. With burnout at an all-time high and staff shortages on the…

Most doctors have patients affected by social drivers but feel ill-equipped to address them, survey finds

March 23, 2022acohealth equity, physicians, SDOH

Doctors have long known that factors such as food insecurity, housing instability, transportation problems and financial problems can impact a patient’s health. Patients who are now returning to physicians’ offices and hospitals for routine checkups, deferred elective procedures, prescription refills and more are presenting with conditions made worse by lost jobs and the struggle to…

Prevention suffers when doctors drop out of Medicare’s ACO program

February 3, 2022acoACOs, Medicare, MSSP, physicians

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…

Physician Quality: What is it, How do you Measure it, and Why is it Important?

January 11, 2022acohealth data, healthcare data, patient data, physicians

What is a “quality” physician? Depending on the stakeholder, there will likely be a different answer. A clinician’s response would vary depending on their specialty, training, and practice setting. At the same time, a patient would place greater value in bedside manner and shared decision making. A payer might tell you it is a clinician…

New ACO Playbook: How To Supercharge Your ACO

October 20, 2021Garrett SchmittNo Commentsaccountable care, ACO, ACO Growth, ACO Performance Pathways, ACO success, ACOs, APP, Data, data sufficiency, Episodes of Care, patients, physicians

Throughout the last decade of ACO development, many have struggled to identify what actually makes ACOs successful. Analyses have been fraught with conflicting conclusions. Studies have tagged type of ownership (hospital-based vs. physician-led), geographic region or urban-rural factors, primary-care-only versus specialty participation, ACO payment model type, patient volume, and operations strategies as links to success…

Physician groups warn nearly 10% in Medicare cuts could stall shift to value-based care, force staff cuts

October 13, 2021Garrett SchmittNo CommentsAmerican Medical Group Association, AMGA, healthcare reform, Medicare, MSSP, physicians, value-based care, vbc

Several medical groups say a new round of cuts to Medicare payments set to go into effect in 2022 will derail their move to value-based care and impact hiring of new staff. Medical groups spoke about the need for Congress to avert a series of cuts during a briefing on Tuesday sponsored by the American…

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…

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