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

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

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 93

Medicare Accountability 93

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 99

Medicare Accountability Accountable Care Prevention 99

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 280

Accountable Care Accountability Medicaid Medicare 280

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

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

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 102

Medicare Hospitals Accountability Medicaid 102

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 147

Accountable Care Accountability Medicare 147

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 279

Accountable Care Medicare Accountability Medicaid 279

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 274

Medicare Medicaid Integration Quality of Care 274

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 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 84

Medicare Accountability Medicaid 84

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 88

Accountable Care Accountability Primary Care Medicare 88

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

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

Health Populi

JUNE 17, 2024

You would assume that most people over 50 would be worried about the financial future of Medicare to cover health care as those middle-aged Americans age. See that the stats on pessimism running high for the prospects of wellbeing — financial, quality of life, and physical health — are greater when accounting for people under 65.

Medicare 71

Medicare Medical Services Integration Regulations 71

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 96

Medicare Accountable Care Accountability Medicaid 96

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 328

Accountability Medicare Hospitals 328

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 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 76

Medicare Hospitals Accountability Doctors 76

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 264

Accountable Care Accountability Medicare 264

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 300

Accountable Care Accountability Patient Experience Medicare 300

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

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 104

Medicare Accountable Care Home Care Accountability 104

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

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 173

Accountable Care Accountability Medicare 173

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 214

Accountable Care Accountability Physical Therapy Nursing 214

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 162

Primary Care Accountable Care Accountability Medicaid 162

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 245

Accountable Care Regulations Accountability Medicare 245

Home Health Care

AUGUST 1, 2022

Federal watchdogs reported the Centers for Medicare & Medicaid Services (CMS) has not collected the near-$500 million in Medicare overpayments that were found in audits over a two-year period beginning in 2014. The post CMS, OIG Disconnect Highlighted In Medicare Overpayments Report appeared first on Home Health Care News.

Medicare 103

Medicare Medicaid Accountability 103

NASHP

SEPTEMBER 5, 2023

On August 29, the Centers for Medicare & Medicaid Services (CMS) announced the first 10 prescription drugs that will be subject to negotiation for Medicare under the Inflation Reduction Act (IRA). CMS will publish the MFPs on September 1, 2024, and they will be effective on January 1, 2026 for all purchases under Medicare Part D.

Medicare 76

Medicare Accountability Medicaid 76

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

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

NASHP

AUGUST 21, 2023

The National Academy for State Health Policy (NASHP) is pleased to announce a new initiative to work with states to strengthen oversight and accountability of managed long-term services and supports (MLTSS) plans, with a particular focus on payment strategies. To get updates about this opportunity, sign up for NASHP’s weekly newsletter.

Accountability 52

Accountability Medicaid Medicare 52

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 116

Medicare Rehabilitation Home Care Accountable Care 116

Fierce Healthcare

AUGUST 24, 2023

The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) has saved a net $1.8 billion in 2022 for accountable care organizations, which is th | Accountable care organizations saved a net $1.8

Accountable Care 130

Accountable Care Accountability Medicare Medicaid 130