CMS needs to provide more support to small, physician-led ACOs or risk drop-outs: report

February 13, 2020Garrett SchmittNo CommentsACOs, CMS, Pathways to Success, Stark Law

Small physician-led Accountable Care Organizations (ACOs) have shown success in reducing costs while improving quality. But they need more support to continue down that road, according to a new report. Those ACOs would benefit from more guidance and support from the Centers for Medicare & Medicaid Services (CMS), private insurers and other sources as they…

3 Reforms Aim to Reduce Administrative Burden of Value-Based Care

October 11, 2019Garrett SchmittNo CommentsMGMA, MIPS, Stark Law

As the industry transitions from the fee-for-service model to value-based care, many providers are finding themselves struggling to straddle the divide. The shift away from volume has created many new administrative burdens that are handicapping providers’ ability to focus on patient care. In an effort to alleviate these significant provider burdens, CMS recently sent out…

HHS’ massive Stark overhaul prompts optimism for value-based care models

October 9, 2019Garrett SchmittNo CommentsMGMA, Stark Law, VBHC

Many of the top health system and provider groups lauded the Department of Health and Human Services’ (HHS’) proposed regulations aimed at updating the decades-old Stark Law saying they believe it is the start to removing major regulatory headaches stymying the shift to value-based care models. The Centers for Medicare & Medicaid Services (CMS) and…

Medical Groups Call for Value-Based Care Reforms to Reduce Burden

August 13, 2019Garrett SchmittNo CommentsAMGA, MGMA, Stark Law

Operating with one foot in fee-for-service and the other in value-based care has created significant administrative burdens for providers, so medical groups are now offering CMS value-based care reforms to simplify the model and move more providers away from volume. In response to a request for information on how to reduce administrative burdens, AMGA (American…

Stark law changes to open up value-based model participation, Verma says

March 4, 2019Garrett SchmittNo CommentsSeema Verma, Stark Law

CMS Administrator Seema Verma gave her first update on a major overhaul to the Stark law, saying that a key part of the regulation will remove a barrier to doctors participating in value-based arrangements. A major part of the agency’s updates to the anti-kickback law is clarifying areas of noncompliance for doctors and updating the…

On Capitol Hill, Healthcare Leaders Raise Concerns with CMS’ Proposed ACO Rule

September 17, 2018Garrett SchmittNo CommentsStark Law

A panel of healthcare organization leaders voiced concerns about moving Medicare accountable care organizations (ACOs) to two-sided risk too quickly, as proposed in a recent federal draft rule, and highlighted the need for Stark Law reform during a U.S. House of Representatives Health subcommittee hearing last week. The U.S. House of Representatives Energy and Commerce…

Supporting the Independent Practice in a Value-Based Care System

July 16, 2018Garrett SchmittNo CommentsAdvanced Alternative Payment Models, APM, APMs, EHR, Independent, Independent Practices, MIPS, QPP, Stark Law

Value-based care is touted as a way of incentivizing providers to achieve the triple aim: delivering high quality care, improving population health management, and lowering healthcare costs. While shifting from a fee-for-service model to a value-based care system has the potential to improve patient health outcomes and save healthcare organizations money, the transition from the…

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