Beyond Participation: What CMS’s New Value-Based Care Models Have in Common

Garrett SchmittNo Comments, ,

Recently, the Centers for Medicare & Medicaid Services has accelerated a fundamental redesign of Medicare value-based care through a new wave of models that are reshaping how organizations manage surgical episodes, chronic conditions, ambulatory specialty care, and population health. This transformation extends beyond hospitals and health systems, impacting physician groups, specialists, post-acute providers, and community-based…

How Will CMS’S V28 HCC Model Impact RAF Scores?

Garrett SchmittNo Comments, ,

The Centers for Medicare & Medicaid Services (CMS) introduced the Risk Adjustment Factor (RAF) model in 2004, which was designed to estimate future healthcare costs for patients. RAF scores are a critical component of value-based care, as they help predict healthcare resource utilization while adjusting for quality and costs for patients. With the introduction of the v28 HCC…

Improving The Health Of Rural Americans

Garrett SchmittNo Comments, , , , , , , , , , ,

People living in rural America have lower incomes, less education, and are in poorer health than those living in other areas of the United States. For more than a century, these measures have been “sticky” with little change despite many efforts to do so. It is also well-known that most rural areas have a shortage of primary care and specialist physicians and lack of…

Bill aims to fix glitch that penalizes rural ACOs even if they generate savings

Garrett SchmittNo Comments, , , , ,

New bipartisan legislation aims to fix a glitch that can penalize rural accountable care organizations that reduce costs. The legislation, introduced Tuesday, would fix a flaw that requires all ACOs to measure their performance against themselves, which lawmakers say can disproportionately impact rural providers. The bill comes as ACO advocates have been worried about a…

The CHART Model: What it means for ACOs and Health Communities in 2020

Garrett SchmittNo Comments, ,

On August 11, 2020, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced the new Community Health Access and Rural Transformation (CHART) Model as part of the President’s recent executive order. The Model is an incredible accomplishment for patients and healthcare providers in rural areas that face social determinants of health (SDOH) challenges,…

CMMI Announces New Model to Support Rural Value Transformation

Garrett SchmittNo Comments,

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) announced a new model designed to test approaches to supporting rural providers and communities in their efforts to transform their care delivery systems to promote accessible, high-value care. The new Innovation Center (CMMI) initiative, called the Community Health Access and Rural Transformation (CHART) Model,…

CMS unveils new alternative payment model for rural health

Garrett SchmittNo Comments,

The Centers for Medicare and Medicaid Innovation on Tuesday unveiled a new alternative payment model for rural providers. The Community Health Access and Rural Transformation—CHART—model will give rural communities money upfront to change how they pay for and deliver care to Medicare beneficiaries. It will also provide them with operational and regulatory relief, as well as technical…

ACOs and Rural Healthcare

Garrett SchmittNo Comments, , ,

Roughly 20 percent of the United States population lives in rural areas. Despite this, rural America faces a number of health-related challenges, some of which are structural, while some are related to regional differences in health and health care in this country. Compounding these issues, incomes are lower and poverty rates are higher in many…