Health Business Group

JULY 18, 2024

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

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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 (..)

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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.

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Medicare Accountable Care Accountability 242

Home Health Care

MAY 15, 2022

Accountable care organizations (ACOs) have considerably increased their home-based care arsenals over recent years. They’ve also diversified the types of home-based care they offer, and are finally finding ways for it to make economic sense in capitated models. Source: Institute for Accountable Care.

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Accountable Care Accountability Primary Care Medicare 97

Healthcare It News

MARCH 4, 2022

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? Post-acute care is a key part of the care continuum and a significant component of healthcare spend. Medicare spends nearly $60 billion on post-acute care annually.

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Accountable Care Accountability Physical Therapy Nursing 210

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, (..)

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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.

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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.

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Accountable Care Accountability Medicare 263

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).

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Medicare Accountability Accountable Care Prevention 106

HIT Consultant

JULY 13, 2022

For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Moving forward, organizations will have to build infrastructure that can collect health equity data, report on it and service all Medicare beneficiaries.

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Accountability Accountable Care Primary Care Medicare 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.

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Accountable Care Accountability Medicaid Medicare 207

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.

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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.

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Accountable Care Accountability Medicare 264

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.

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Accountable Care Medicare Accountability 262

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. Similar MA grievances can be heard from beyond home health care as well. Similar MA grievances can be heard from beyond home health care as well.

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Medicare Rehabilitation Medicaid Accountable Care 111

Healthcare ECONOMIST

JANUARY 18, 2022

An interesting article in Modern Healthcare reviews some discussion at a recent Medicare Payment Advisory Commission (MedPAC) meeting. The first issue is that the pool of fee-for-service Medicare beneficiaries is shrinking, at least on a relative basis.

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Accountable Care Accountability Medicare Healthcare 64

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.

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Medicare Accountable Care Accountability Medicaid 98

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.

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Medicare Accountable Care Accountability Quality of Care 90

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.

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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.

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Accountable Care Accountability Medicaid Medicare 130

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.

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Accountable Care Regulations Accountability Medicare 245

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.

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Accountable Care Accountability Medicare 179

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. |

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Accountable Care Accountability Medicare 170

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 (..)

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Primary Care Accountable Care Accountability Medicaid 159

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.’

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Medicare Accountable Care Home Care Accountability 114

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

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Accountable Care Accountability Medicare Medicaid 130

Fierce Healthcare

FEBRUARY 21, 2024

The blueprint set forth by Massachusetts accountable care organizations to improve population health metrics and reduce costs can be applied to New York, after Centers for Medicare & Medic | New York's section 1115 waiver allocates $500 million toward social care networks to connect community health workers with local organizations.

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Accountable Care Population Health Accountability Medicare 159

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.

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Medicare Rehabilitation Home Care Accountable Care 116

HIT Consultant

NOVEMBER 21, 2023

a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year. What You Should Know: NextGen Healthcare, Inc.

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Medicare Population Health Accountable Care Quality of Care 52

Sheppard Health Law

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

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Medicare Accountable Care Primary Care Accountability 52

Home Health Care

JUNE 16, 2022

The Medicare Payment Advisory Commission (MedPAC) is, once again, calling for federal policymakers to streamline alternative payment models within the Medicare program. MedPAC examined rural beneficiaries’ and MUA-based individuals’ access to care. In June 2021, MedPAC recommended that the U.S. Home health access.

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Medicare Medicaid Accountable Care Accountability 104

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).

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Primary Care Medicare Accountable Care Accountability 110

HIT Consultant

OCTOBER 12, 2021

– Bamboo Health’s ACO partners succeed under value-based care programs like the MSSP by utilizing their Pings solution, which provides real-time visibility into patient admission, discharge, and transfer (ADT) care events.

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Medicare Care Transition Accountable Care Accountability 52

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. million people in 2024 along with Traditional Medicare associated with an ACO.

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Quality of Care Doctors Medicare Patient Experience 130

Home Health Care

MAY 11, 2022

The highly fragmented home health industry has turned providers into commodities, at least in the eyes of Medicare Advantage (MA) organizations. Because there are so many providers looking to make managed care inroads, the rates home health operators receive from MA sources are typically far below what they get from fee-for-service Medicare.

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Medicare Rehabilitation Accountability Accountable Care 91

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.

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Medicare Accountable Care Accountability Medicaid 246

Healthcare Leadership Council

MAY 25, 2022

Crippen, former director of the Congressional Budget Office and currently a Healthcare Leaddership Council consultant, that should be a catalyst for discussion on a critical element of the Center for Medicare and Medicaid Innovation’s future direction.

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Medicare Medicaid Accountable Care Quality Improvement 75