Health Care Dive

OCTOBER 21, 2021

Officials acknowledged provider concerns that current models are too burdensome and benchmarks too complex, which the innovation center aims to rectify.

Accountable Care 256

Accountable Care Accountability Medicare 256

Health Care Dive

APRIL 17, 2024

Independent practices have clearer financial incentives to lower medical spending than hospitals participating in accountable care organizations, according to the Congressional Budget Office.

Accountable Care 343

Accountable Care Medicare Accountability Hospitals 343

Health Care Dive

MAY 20, 2024

On Friday, the committee released a white paper proposing Medicare adjust doctor reimbursement to account for inflation, a key goal for physician lobbies.

Medicare 232

Medicare Accountability Doctors 232

p3care

NOVEMBER 25, 2020

In the last quarter of 2020, CMS (Centers for Medicare & Medicaid Services) announced the performance scores for clinicians of QPP MIPS 2019 on its official site. It accounts for quality healthcare services, that CMS recognizes and rewards for. Check Points for Performance Review.

Medicare 238

Medicare Accountability Doctors Medicaid 238

Healthcare It News

MARCH 30, 2022

Department of Health and Human Services Office of Inspector General released a study examining how Medicare beneficiaries used telehealth during the first year of the COVID-19 pandemic. "Telehealth was critical for providing services to Medicare beneficiaries during the first year of the pandemic," read the report.

Medicare 239

Medicare Medicaid Integration Quality of Care 239

Fierce Healthcare

APRIL 11, 2024

Accountable care organizations have sounded the alarm on billions in durable medical equipment fraud, and officials at the Centers for Medicare & Medicaid Services (CMS) said Thursday that the | Accountable care organizations have sounded the alarm on billions in durable medical equipment fraud, and officials at the Centers for Medicare & Medicaid (..)

Accountable Care 259

Accountable Care Accountability Medicaid Medicare 259

Health Care Dive

JULY 8, 2022

Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.

Accountable Care 315

Accountable Care Accountability Medicare 315

Fierce Healthcare

JANUARY 29, 2024

In 2024, 50 accountable care organizations are new to the Medicare Shared Savings Program and 71 ACOs renewed participation, according to new numbers released by Centers for Medicare & Medicaid | CMS released new data Monday showing ACO participation in the Medicare Shared Savings Program, with 19 ACOs set to participate in a new payment option, (..)

Accountable Care 262

Accountable Care Medicare Accountability Medicaid 262

Fierce Healthcare

DECEMBER 13, 2023

A jump in claim delays and denials is “wreaking havoc on providers’ revenue cycle performance” and contributing to health systems’ “volatile” accounts receivable and diminishing cash reserves, acco | More frequent pushback from commercial and Medicare Advantage payers is complicating patient self-pay collections and, ultimately, undermining the revenues (..)

Accountability 309

Accountability Medicare Hospitals 309

Health Care Dive

JANUARY 24, 2023

Rush University will be the only Chicago-area academic medical center participating in CVS’ first accountable care organization in ACO REACH.

Medicare 223

Medicare Accountable Care Accountability 223

Fierce Healthcare

JUNE 8, 2023

Phase 1 enrollment in the Medicare Shared Savings Program (MSSP) for 2024 is currently underway, and recent reforms hold promise in attracting new providers into accountable care.

Accountable Care 254

Accountable Care Accountability Medicare 254

Fierce Healthcare

NOVEMBER 11, 2024

Accountable care organizations in the ACO Reach program can claim credit for saving the Centers for Medicare & Medicaid Services (CMS) hundreds of millions of dollars | CMS released favorable savings results for ACO REACH Model participants, as industry group NAACOS begins to push for the program's extension through 2030.

Accountable Care 269

Accountable Care Accountability Medicaid Medicare 269

Health Care Dive

AUGUST 25, 2023

Nearly two-thirds of participating accountable care organizations earned payments for their performance last year, according to the CMS.

Medicare 204

Medicare Accountable Care Accountability 204

Fierce Healthcare

NOVEMBER 29, 2023

Accountable care organizations do not positively influence treatment and outcomes for chronic mental health conditions for Medicare patients, according to a study in Health Affairs. | A new study pours water on the belief that ACOs are well-suited to handle chronic mental health conditions its patients experience.

Accountable Care 276

Accountable Care Accountability Patient Experience Medicare 276

Health Care Dive

DECEMBER 9, 2022

Accountable care organizations' net savings rates ranged from -29.4% in the 2021 Global and Professional Direct Contracting Model.

Accountable Care 220

Accountable Care Medicare Accountability 220

Healthcare It News

MARCH 4, 2022

Medicare spends nearly $60 billion on post-acute care annually. Why do you suggest that care coordination with post-acute providers will become more critical than before to support the rise of value-based care? What needs to happen? Post-acute care is a key part of the care continuum and a significant component of healthcare spend.

Accountable Care 184

Accountable Care Accountability Physical Therapy Nursing 184

Health Care Dive

DECEMBER 6, 2023

The beleaguered insurer will leave the accountable care program at the end of the 2023 performance year following disappointing results in Medicare direct contracting.

Accountable Care 231

Accountable Care Accountability Medicare 231

HIT Consultant

JULY 13, 2022

has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Recently, CMMI stated that by 2030 every Medicare beneficiary should be in a value-based relationship – either an ACO or ACO-like model or Medicare Advantage – with a significant emphasis on health equity.

Accountability 98

Accountability Accountable Care Primary Care Medicare 98

Home Health Care

JUNE 26, 2024

Centers for Medicare & Medicaid Services (CMS) published its FY 2025 home health proposed payment rule Wednesday. Overall, CMS estimates that Medicare payments to home health agencies in CY 2025 would decrease in the aggregate by 1.7%, or by about $280 million, compared to 2024 levels. This is a developing story.

Medicare 123

Medicare Medicaid Accountability 123

Healthcare ECONOMIST

MAY 5, 2024

To account for differences in disease burden across a Medicare Advantage (MA) plans patient population, uses risk adjustment based on patient disease burden. One key question is whether providers under traditional Medicare (TM) code differently than Medicare Advantage (MA) plans. diabetes, heart failure).

Medicare 111

Medicare Accountability Accountable Care Prevention 111

Health Care Dive

AUGUST 15, 2023

Regulators lowered enrollment minimums for accountable care organizations in the program, which allows providers to form groups to manage care and costs for fee-for-service Medicare enrollees.

Accountable Care 217

Accountable Care Regulations Accountability Medicare 217

p3care

FEBRUARY 10, 2021

From the next performance year (2021), Accountable Care Organizations (ACOs) expect different reporting requirements under the Medicare Shared Savings Program. CMS (Centers for Medicare and Medicaid Services) has recommended changes for ACO reporting criteria. The requirements are somewhat the same as for QPP MIPS.

Medicare 246

Medicare Accountable Care Accountability Medicaid 246

Healthcare ECONOMIST

JULY 21, 2023

The Kaiser Family Foundation (KFF) identifies the Part D drugs on which Medicare spends the most money. In 2021, Medicare Part D covered more than 3,500 prescription drug products, with total gross spending of $216 billion, not accounting for rebates paid by drug manufacturers to pharmacy benefit managers (PBMs).

Medicare 98

Medicare Accountability Medicaid 98

Fierce Healthcare

AUGUST 2, 2024

The Centers for Medicare & Medicaid Services (CMS) quietly released changes to the ACO REACH Model, prompting one industry group to react to the modifications. Accountable care organizations are evaluating the impacts of the new requirements for the ACO REACH program. So far, the changes are a mixed bag, says NAACOS.

Accountable Care 188

Accountable Care Accountability Medicaid Medicare 188

Health Populi

AUGUST 3, 2021

“You can trust us to help you find the right Medicare coverage for you and your lifestyle,” the tagline reads. It is, specifically, Midwest Heritage, Hy-Vee’s banking, insurance and investments subsidiary, that will implement the Medicare Aisle program.

Medicare 127

Medicare Primary Care Accountability Integration 127

Home Health Care

AUGUST 30, 2021

CommonSpirit Health carved out $136 million in savings to Medicare for 2020, while also improving overall outcomes for hundreds of thousands of beneficiaries, the company recently announced. CommonSpirit Health is a participant in the Medicare Shared Savings Program (MSSP), which began back in 2012 after being designed by the U.S.

Medicare 111

Medicare Rehabilitation Home Care Accountable Care 111

Healthcare It News

APRIL 5, 2024

Based on its initial investigation, the following information may have been accessed by hackers: name, address, birth date, email, telephone number, marital status, Aboriginal status, Medicare number, referring doctor, and type of diabetes.

Medicare 260

Medicare Hospitals Accountability Doctors 260

HIT Consultant

JANUARY 25, 2024

What You Should Know: The Ohio State University Wexner Medical Center a nd CVS Accountable Care, part of CVS Health® (NYSE: CVS), today announced the creation of an accountable care organization (ACO) to improve the quality of care for Medicare beneficiaries by Ohio State providers in central Ohio.

Medicare 90

Medicare Accountable Care Accountability Quality of Care 90

Home Health Care

MAY 29, 2024

Medicare Advantage (MA) – the offshoot of traditional Medicare that’s administered by private insurance companies – has recently caught a lot of flak. Centers for Medicare & Medicaid Services (CMS) has been collecting feedback on the MA program through a request for information (RFI) process.

Medicare 107

Medicare Rehabilitation Medicaid Accountable Care 107

Fierce Healthcare

APRIL 16, 2024

CVS Accountable Care and inVio Health Network, a collection of more than 600 providers in South Carolina, are partnering to improve care outcomes for 60,000 Medicare beneficiaries. |

Accountable Care 152

Accountable Care Accountability Medicare 152

Fierce Healthcare

JULY 1, 2024

Accountable care organizations concerned they would be held responsible for bad actors exploiting the Medicare system can breathe a sigh of relief. ACOs may soon be able to take a breath of fresh air, as CMS shared Friday that it has no intention of punishing them for a urinary catheter fraud scandal.

Accountable Care 159

Accountable Care Accountability Medicare 159

Healthcare It News

OCTOBER 13, 2023

Social determinants of health – the food, shelter and security attributes of patients that exist outside of care settings – contribute disproportionate risks for disease, hospital readmissions and a lack of access to quality healthcare among vulnerable populations, including people on Medicare.

Accountability 226

Accountability Population Health Regulations Medicare 226

Home Health Care

NOVEMBER 27, 2024

One comment you made at HHCN’s FUTURE event, which I thought was interesting, was that there needs to be a maturation process in the home health industry in order to capitalize off of some of the opportunities that are out there, specifically in Medicare Advantage (MA). In a lot of cases, the home-based care isn’t accountable.

Accountability 71

Accountability Hospice Care Medicare Nursing 71

Fierce Healthcare

MARCH 19, 2024

The Centers for Medicare & Medicaid Services (CMS) has announced the ACO Primary Care Flex Model (ACO PC Flex Model), allowing eligible accountable care organizations to treat people with with | Accountable care organizations are largely supportive of CMS' new primary care model released Tuesday, they wish the agency would broaden its scope (..)

Primary Care 145

Primary Care Accountable Care Accountability Medicaid 145

Sheppard Health Law

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. 3d 1, 18 n.19

Medicare 105

Medicare Medicaid Accountability Integration 105

Healthcare ECONOMIST

NOVEMBER 29, 2023

Just this year a majority of Medicare beneficiaries enrolled in a Medicare Advantage plan. While these plans are popular with patients, I recently wrote that some rural providers are refusing to accept Medicare Advantage due to low reimbursement.

Medicare 85

Medicare Hospitals Accountability Doctors 85

Healthcare It News

JANUARY 18, 2022

Care managers and social workers, working within accountable care organizations, and physician provider networks now incorporate a short series of SDOH interview questions with patients identified as high-risk for poor healthcare outcomes or unnecessary future healthcare expenditures.

Pharmaceuticals 332

Pharmaceuticals Accountable Care Accountability Medicaid 332