Provider Collaboration Needed to Drive Patient Experience, ACO Success

February 9, 2022acoAPMs, direct contracting, FFS, Interoperability, provider collaboration

In order to ensure accountable care organization (ACO) and patient experience success, providers must collaborate across the continuum of care, suggested a recent study out of the Ohio State University Fisher College of Business. “We found that if an ACO wants to be successful, it needs representation across all parts of a patient’s continuum of care,”…

New Opportunities for Provider Collaboration Stark and Anti-Kickback Statute Standards for Value-Based Care, Part 2: Creating a Value-Based Enterprise

May 6, 2021Garrett SchmittNo Commentsprovider collaboration, vbc

The first step in qualifying to meet the requirements of a value-based Stark exception or a valuebased Anti-Kickback Statute safe harbor is that the parties establish a “value-based enterprise.” The concept of a value-based enterprise is very definitionally driven, so before attempting to create a value-based enterprise it is imperative to fully understand the regulatory…

New Opportunities for Provider Collaboration Stark and Anti-Kickback Statute Standards for Value-Based Care, Introduction

May 3, 2021Garrett SchmittNo Commentsprovider collaboration, vbc

In November of 2020 the Centers for Medicare & Medicaid Services (“CMS”) finalized value- based exceptions under the Stark Law and the Office of Inspector General (“OIG”) finalized value- based safe harbors under the Anti-Kickback Statute, in an effort to accommodate and facilitate the evolution of value-based care arrangements among health care providers. “Value-based care”…

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