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 98

Accountability Hospice Care Medicare Nursing 98

Health Care Dive

DECEMBER 20, 2022

The Government Accountability Office is urging the CMS to resume certain eligibility checks on providers whom they consider at high risk of fraud to the Medicare program.

Medicare 326

Medicare Accountability 326

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 355

Accountable Care Medicare Accountability Hospitals 355

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 298

Accountable Care Accountability Medicare 298

HIT Consultant

APRIL 16, 2024

What You Should Know: – inVio Health Network and CVS Accountable Care Organization, a division of CVS Health , have announced a collaboration to participate in the new Medicare Accountable Care Organization (ACO) REACH program. CVS Accountable Care contributes its extensive experience and resources.

Accountable Care 52

Accountable Care Accountability Medicare Population Health 52

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 276

Accountable Care Accountability Medicaid Medicare 276

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 128

Medicare Medicaid Accountability 128

HIT Consultant

NOVEMBER 21, 2024

Recently, a bipartisan group of lawmakers reintroduced legislation to overhaul the prior authorization process of Medicare Advantage plans. It’s important to understand why this bill narrowly focuses on Medicare Advantage plans and what it hopes to solve. Ultimately, we’re at a critical inflection point.

Medicare 104

Medicare Regulations Accountability Prevention 104

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 106

Medicare Accountability Accountable Care Prevention 106

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

Health Business Group

JULY 18, 2024

In this episode, we dive deep into this pressing question with Dr. Mohamed Diab , president of CVS Accountable Care. Can value-based care transform the American healthcare system? Dr. Diab highlights systemic challenges, such as physician burnout and the inadequacies of primary care funding.

Accountable Care 52

Accountable Care Accountability Life Sciences Primary Care 52

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 277

Accountable Care Accountability Medicaid Medicare 277

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 242

Medicare Accountable Care Accountability 242

Home Health Care

OCTOBER 25, 2024

This article is a part of your HHCN+ Membership The Federation of American Hospitals (FAH) released a statement Thursday regarding recent investigations into Medicare Advantage (MA) plans. Those investigations included concerns around claim denials, as well as discrepancies between MA plan practices when compared to traditional Medicare.

Medicare 105

Medicare Accountability Hospitals Healthcare 105

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 92

Medicare Accountability Medicaid 92

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 264

Medicare Medicaid Integration Quality of Care 264

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 263

Medicare Accountable Care Accountability 263

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 276

Accountable Care Medicare Accountability Medicaid 276

Briggs Healthcare

JANUARY 31, 2023

Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA program payments.

Medicare 40

Medicare Accountability Regulations Medicaid 40

Home Health Care

MAY 15, 2022

Accountable care organizations (ACOs) have considerably increased their home-based care arsenals over recent years. That’s according to the Institute for Accountable Care (IAC), which conducted a wide-ranging study on ACOs and home-based care that was released Thursday. Source: Institute for Accountable Care.

Accountable Care 97

Accountable Care Accountability Primary Care Medicare 97

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

Home Health Care

JUNE 24, 2024

NYSE: EHAB) defended its strategy of taking on more Medicare Advantage (MA) revenue over the last couple of years. Enhabit now has about 61% of its home health revenue tied to fee-for-service Medicare. At that time, traditional Medicare made up approximately 75% of Enhabit’s total Home Health revenue. “At of Enhabit shares.

Medicare 104

Medicare Accountability 104

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 111

Medicare Rehabilitation Medicaid Accountable Care 111

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 263

Accountable Care Accountability Medicare 263

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 82

Medicare Hospitals Accountability Doctors 82

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 327

Accountability Medicare Hospitals 327

Home Health Care

MAY 16, 2024

This article is a part of your HHCN+ Membership If there were ever a time for Medicare Advantage-related troubles to cool off in the home health care space, now would be it. For the first time ever, in 2023, there were more Medicare beneficiaries under an MA plan than traditional Medicare.

Medicare 110

Medicare Hospitals Accountability Medicaid 110

Home Health Care

AUGUST 25, 2023

The Medicare Shared Savings Program (MSSP) continues to save Medicare over a billion dollars annually. And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care.

Medicare 98

Medicare Accountable Care 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 207

Accountable Care Accountability Medicaid Medicare 207

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 262

Accountable Care Medicare Accountability 262

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 297

Accountable Care Accountability Patient Experience Medicare 297

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 264

Accountable Care Accountability Medicare 264

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

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 210

Accountable Care Accountability Physical Therapy Nursing 210

Home Health Care

NOVEMBER 7, 2023

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. million Medicare fee-for-service beneficiaries are assigned to an ACO. Currently, roughly 13.2 We’d like to try it that way.’

Medicare 114

Medicare Accountable Care Home Care Accountability 114

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 331

Accountable Care Accountability Medicare 331

Fierce Healthcare

SEPTEMBER 24, 2024

The Centers for Medicare & Medicaid Services (CMS) finalized a rule (PDF) Tuesday to limit the impact of fraudulent bi | Hoping to help accountable care organizations turn the page on a messy urinary catheter scandal, CMS released a final rule to hold ACOs financially harmless.

Accountable Care 130

Accountable Care Accountability Medicaid Medicare 130