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

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

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

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

Healthcare It News

JANUARY 4, 2022

Progress toward accountable care is halting. "The adoption of hospital-at-home programs across the country has been rapid, with nearly 200 hospitals participating in the Centers for Medicare and Medicaid Services’ Acute Hospital Care at Home program in only a year since its launch," said Majmudar.

Hospitals 335

Hospitals Nursing Accountable Care Clinical Practice 335

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

p3care

OCTOBER 30, 2020

CMS (The Centers for Medicare and Medicaid Services) released the proposed rule for QPP MIPS 2021 via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). Now, it’s time to look into details of (Centers for Medicare and Medicaid Services) CMS-published Proposed Rule. Let’s get started!

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

Home Health Care

OCTOBER 20, 2021

Centers for Medicare & Medicaid Services (CMS) and its main innovation hub touted a “strategy refresh” on Wednesday. Among its key pillars, the refresh calls for greater payment and regulatory flexibilities supporting the provision of home- and community-based care. Officials from the U.S.

Accountable Care 89

Accountable Care Accountability Medicare Medicaid 89

HIT Consultant

APRIL 3, 2023

These risk-based care models are designed to encourage proactive care, better population health and reduced spending across the healthcare spectrum. To meet that deadline, provider organizations will need technology tools for administering relationships within a value-based network.

Accountable Care 98

Accountable Care Accountability Integration Private Practices 98

Healthcare ECONOMIST

OCTOBER 22, 2021

Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Models should encourage lasting care delivery transformation.

Medicare 105

Medicare Accountable Care Accountability Medicaid 105

Home Health Care

MAY 29, 2024

Similar MA grievances can be heard from beyond home health care as well. Centers for Medicare & Medicaid Services (CMS) has been collecting feedback on the MA program through a request for information (RFI) process. In response to the mounting criticism, the U.S.

Medicare 107

Medicare Rehabilitation Medicaid Accountable Care 107

p3care

MAY 31, 2024

An ACO (Accountable Care Organization) works for the better care of patients. Consider it as a group that combines hospitals, doctors, and other healthcare specialists for the sake of providing healthcare and is a team in care decisions. Complying with all these regulations helps in avoiding penalties.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

Home Health Care

AUGUST 25, 2023

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. Centers for Medicare & Medicaid Services (CMS) announced Thursday that MSSP saved Medicare $1.8

Medicare 85

Medicare Accountable Care Accountability Medicaid 85

Sheppard Health Law

OCTOBER 27, 2021

On October 20, 2021, the Centers for Medicare and Medicaid (“ CMS ”) Innovation Center (“ Innovation Center ”) published a white paper detailing its vision for the next ten years: a health system that achieves equitable outcomes through high quality, affordable, person-centered care. Strategic Objective 1: Drive Accountable Care.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

NASHP

AUGUST 23, 2021

Primary care case management (PCCM) programs are one of the oldest types of Medicaid managed care, but over time most states have shifted to use managed care organizations (MCOs) to deliver services to Medicaid participants. million Medicaid participants. million Medicaid enrollees.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

Home Health Care

FEBRUARY 8, 2024

This article is a part of your HHCN+ Membership Home-based care providers avoiding the shift to value-based care are running out of time and excuses. Home health providers are already under the Home Health Value-Based Purchasing (HHVBP) Model, which is, by definition, a value-based care model. “In

Medicare 108

Medicare Accountable Care Accountability Primary Care 108

NASHP

DECEMBER 10, 2021

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs ACO Accountable Care Organizations. CBCM Community Based Care Management Program. MCO Managed Care Organizations.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

NASHP

AUGUST 5, 2024

CHWs are key to engagement, care coordination, and increasing access to clinical and support services for Medicaid enrollees from their communities. As such, states increasingly are pursuing Medicaid reimbursement options as part of a comprehensive CHW service financing approach, which is currently reliant on expiring grant programs.

Medicaid 52

Medicaid Primary Care Prevention Accountability 52

HIT Consultant

MARCH 15, 2023

A June 2022 report from Medicaid and CHIP Payment and Access Commission (MACPAC) further illuminated the issue, explicitly citing an extension of the financing through state Medicaid programs to drive health IT adoption as a decisive step to addressing gaps in access, outcomes data, and oversight.

Accountability 98

Accountability Accountable Care Medicaid Healthcare Innovation 98

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. Currently, roughly 13.2 million Medicare fee-for-service beneficiaries are assigned to an ACO.

Medicare 88

Medicare Accountable Care Home Care Accountability 88

HIT Consultant

OCTOBER 30, 2023

Under the Medicare Shared Savings Program, a healthcare provider that is an Accountable Care Organization (ACO), ACO participant, or ACO provider or supplier would be deemed ineligible to participate in the program for a period of at least one year.

Medicare 98

Medicare Accountable Care Healthcare Providers Regulations 98

Home Health Care

AUGUST 30, 2021

Centers for Medicare and Medicaid Services (CMS). The overall goal of the program is to improve patient care and curb health care costs. Currently, CommonSpirit Health operates more than 1,000 care sites and 142 hospitals across 21 states. Plus, it boasts an average quality score of 98%.

Medicare 111

Medicare Rehabilitation Home Care Accountable Care 111

NASHP

SEPTEMBER 8, 2023

Over the past two years, the seven state teams that participated in the MCH PIP Policy Academy, comprised of officials from state Medicaid, public health, and other relevant agencies/groups (e.g., The state Medicaid agency is in the process of standing up this case management program based on input received during these sessions.

Medicaid 80

Medicaid Performance improvement Quality Improvement Accountable Care 80

Home Health Care

NOVEMBER 13, 2024

Medical Management, the home-based care company HarmonyCare raised $200 million in June. On Wednesday, it touted its success in the Accountable Care Organization (ACO) “REACH” Model, the successor to the The Global and Professional Direct Contracting Models (GPDC).

Primary Care 87

Primary Care Medicare Accountable Care Accountability 87

Healthcare ECONOMIST

MAY 1, 2023

First, admission directly into an NH for an SNF stay is not allowable within traditional Medicare, meaning that admission without entering the hospital requires private payment or Medicaid, for those already eligible. Second, hospital stays shorter than 3 days do not generate a Medicare-covered SNF stay. You can read the full article here.

Hospitals 81

Hospitals Medicare Nursing Accountable Care 81

Home Health Care

SEPTEMBER 29, 2021

In July 2020, VanOosten told Home Health Care News that the program would fall under the system’s Care at Home department, which includes all of the work UnityPoint does for its accountable care organization (ACO) and at-risk contracts. We really believe home is where people are meant to recover.”.

Home Care 102

Home Care Accountable Care Hospitals Accountability 102

Home Health Care

AUGUST 3, 2022

The company made its first major splash on the public market when it acquired Caravan Health – an accountable care organization (ACO) manager – in February for $250 million. It has recently dealt with a bit of a shakeup, however.

Accountable Care 86

Accountable Care Accountability Medicaid Home Care 86

Home Health Care

MARCH 19, 2024

The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary model Tuesday – centered around primary care providers – that could offer home-based care providers more opportunity to dive into risk-based care. The model was another creation of the CMS Innovation Center.

Primary Care 73

Primary Care Medicare Accountable Care Medicaid 73

HIT Consultant

AUGUST 23, 2022

The Center for Medicare and Medicaid Services (CMS) is leading the charge in value-based-care, with recent updates, including the CY 2023 Medicare Advantage Rate Notice to its CY 2023 Physician Fee Schedule (PFS) Proposed Rule.

Medicare 98

Medicare Accountable Care Medicaid Hospitals 98

Home Health Care

JUNE 20, 2023

By the time Rinn takes over, the Centers for Medicare & Medicaid Services (CMS) will have proposed its home health payment rule for 2024, but the final rule will come after his time at VNAHG has begun. As a long-time member of the VNA family, I heartily welcome this opportunity to help move health care forward for all our communities.”

Nursing 84

Nursing Accountable Care Accountability Medicaid 84

GoMoHealth

OCTOBER 20, 2022

While most managed care organizations go to great lengths to comply with Medicaid and Medicare mandates, many are still struggling to meet their goals. Decreased gaps in care and population disparities : closed gaps in care for engaged members of a U.S. Billing, coding, and reimbursement opportunities captured.

Quality Improvement 87

Quality Improvement Medicaid Population Health Medicare 87

Home Health Care

SEPTEMBER 15, 2023

Also based in Dallas, Steward Health Care operates 33 hospitals across Arizona, Arkansas, Florida, Massachusetts, Ohio, Pennsylvania and Texas. It is also one of the nation’s largest accountable care organizations, according to the company’s website. ” Tortorella joins the home health industry at an interesting time.

Urgent Care 95

Urgent Care Hospice Care Accountability Accountable Care 95

Sheppard Health Law

DECEMBER 12, 2022

The Centers for Medicare & Medicaid Services (CMS) Innovation Center continues to move forward with its “strategic refresh” initiative. Through this shift, CMS aims to examine and enhance payments for specialty care provided to Medicare beneficiaries. Value-Based Care and ACOs.

Accountable Care 52

Accountable Care Accountability Medicare Primary Care 52

Home Health Care

FEBRUARY 1, 2023

After the Centers for Medicare & Medicaid Services (CMS) released a final rule that poses sizable risk to its Medicare Advantage business, Humana Inc. Medicare President George Renaudin is also now going to lead Humana’s Medicaid efforts. NYSE: HUM) leaders insisted panic was not necessary. The company also announced new leaders.

Medicare 83

Medicare Primary Care Medicaid Accountable Care 83

Home Health Care

JUNE 16, 2022

Centers for Medicare & Medicaid Services (CMS) decrease the number of Medicare alternative payment models, and instead design models to work together more harmoniously. MedPAC examined rural beneficiaries’ and MUA-based individuals’ access to care. In June 2021, MedPAC recommended that the U.S.

Medicare 79

Medicare Medicaid Accountable Care Accountability 79

Healthcare Success

JULY 5, 2022

Traditional fee for service, accountable care, concierge service, HMOs, cash-only vs. private insurance-only vs. Medicaid/Medicare—all produce different incentives and behaviors because the compensation model impacts how your product/service gets paid for and by whom.

Doctors 157

Doctors Private Practices Accountability Hospitals 157

Home Health Care

DECEMBER 10, 2024

In 2022, CareMax acquired the Medicare value-based care business of Steward Health Care System. The business included a Medicare Direct-Contracting Entity (DCE) and two Medicare Shared Savings Program (MSSP) and accountable care organizations (ACOs). Steward filed for bankruptcy in May.

Primary Care 57

Primary Care Medicare Accountable Care Accountability 57