The healthcare sector faces economic pressures as consumers assume greater financial responsibility for their care and government payers roll out aggressive, value-based reimbursement models. These factors are pushing providers to deliver more integrated, team-based, coordinated care. To achieve these goals, healthcare systems must transform their IT, processes and organizational infrastructures, as well as their organizational…
Americans deserve high-quality, affordable health care choices, and value-based care arrangements play a critical role in delivering on that commitment. Health insurance providers are focused on delivering value to patients, and Prominence Health Plan’s experience with a value-based shared-savings program underscores this. Prominence operates seven Accountable Care Organizations (ACOs) that reward physicians who lower health care costs and improve…
Accountable care organizations (ACOs) lowered Medicare spending by $755 million from 2013 to 2017, a new analysis found. The analysis, released Tuesday by analytics firm Dobson, DaVanzo & Associates, comes as ACOs are working to meet new federal regulations from the Centers for Medicare & Medicaid Services (CMS) to make them take on financial risk…
Fourteen healthcare industry groups, including the American Hospital Association (AHA) and the American Medical Association (AMA), recently backed the campion to Senate legislation that would alter accountable care organization (ACO) benchmarking in Medicare’s largest ACO program. The Accountable Care in Rural America Act (H.R. 5212) would change title XVII of the Social Security Act to…
As healthcare continues to shift toward value-based care, technology that boosts patient engagement, harnesses all available data for informed decision-making and enables more effective treatments will be increasingly vital for health systems to succeed. But limited resources and lack of reimbursement for these technologies remain significant barriers, according to the third annual Top of Mind for…
Launched by the Centers for Medicare and Medicaid Services (CMS) in 2012, the Medicare Shared Savings Program (MSSP) is the largest Medicare accountable care organization (ACO) initiative and a core endeavor among efforts to transition from fee-for-service to alternative payment models. Existing evidence suggests modest success: ACOs have reduced spending a bit—even after accounting for bonus payments—and they appear to…
During the FLAACOS 2019 Conference John Schmitt, Executive VP of ACO ExhibitHall.com (ACOEH) and Dr. Brent Staton, CEO of CCHI ACO and ACOEH Advisory Board member, participated as panel members answering questions with respect to Value-Based strategies for ACOs. A summary of survey responses from ten other ACOEH Advisory Board members to the panel’s questions…
Although legislative pressure to transition to value-based care began several years ago, movement to alternative payment models (APMs) and changes to healthcare reimbursement have been slow, according to CHIME HealthCare’s Most Wired report. The report, recently made public, was based on responses to CHIME’s 2019 Most Wired survey. CHIME (the College of Healthcare Information Management Executives) conducts…
Americans are living longer, and the cost of healthcare is continuing to rise. In a 2012 article published in JAMA, founder of the Institute for Healthcare Improvement and former CMS Administrator Donald Berwick, MD, suggested one third of spending on U.S. healthcare is wasted. Value-based care and population health are ways to address the rising costs…
In July, the Centers for Medicare and Medicaid Services (CMS) proposed a number of changes to its Quality Payment Program and the Merit-based Incentive Payment System (MIPS). Under existing MIPS policy, clinicians are evaluated based on performance in the four separate domains of quality, improvement activities, cost, and promoting interoperability. Stakeholders, including physicians and policy groups, have voiced concerns about…
