HHS on Monday launched an ambitious, double-pronged strategy to shift primary care from fee-for-service payments to a global fee model where clinicians and hospitals could assume varying amounts of risk. HHS Secretary Alex Azar told a crowd of stakeholders at the American Medical Association in Washington that the CMS projects the new voluntary programs will…
The experimental phase of Medicare ACOs has been officially declared dead, per CMS. Going forward, ACOs must agree to take on financial risk for expenditures beyond their targets. That’s sobering news for the majority of ACOs still struggling to succeed. The reality is that most ACOs are bootstrapped—light on extra funding and dependent on existing tools…
Commercially insured members who were cared for by providers that shared financial risk with payers saw higher clinical quality and lower costs on average in 2017, according to benchmarking tool Atlas. The analysis is based on data from seven health plans that represent 7.2 million lives in California. That’s about 55 percent of the state’s entire…
Despite the many uncertainties in the current health care delivery environment, payers and providers continue to demonstrate considerable interest in alternative payment models, including Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs). At the same time, concerns persist about the ability of the MSSP to provide a sustainable pathway toward transformation for health care…
Download Slides Learning Objectives for this session: Connect consolidated 3-year health history to provider EHRs Create actionable data for providers in their EHRs Use text message notifications to bring actionable data to consumers Visit Health Endeavors
Cleveland-based University Hospitals (UH) is launching an Emergency Medical Services Accountable Care Network (EMSACN) that will link EMS providers using common protocols and ongoing measurement to improve emergency response and support EMS innovation. The EMSACN coordinated environment will enable participating EMS providers to increase value by creating a low-cost, high-quality unified healthcare network that is delivered outside…
Beginning June 11, hospitals, physicians and other eligible providers may submit notices of intent to apply to participate in the Jan. 1, 2020 start date for the Medicare Shared Savings Program. Applicants must submit a notice of intent by June 28 at 12 p.m. ET to apply to the Basic or Enhanced track of the program, for…
The Centers for Medicare & Medicaid Services has released a toolkit highlighting innovative strategies that Medicare accountable care organizations use to coordinate and manage care for their diverse beneficiary populations. “Approaches to care coordination include both system-wide initiatives and targeted interventions that support individuals with chronic conditions or recent acute care needs,” the toolkit notes. “Some ACOs…
High-need, high-cost (HNHC) individuals are defined as people of all ages living with clinically complex needs and functional limitations who also incur high health care costs or are likely to do so in the near future. Despite frequent contact with the health care system and substantial medical spending, the physical, social, and behavioral health needs of these…
Download Slides Over 30 million US citizens are members of an ACO. While ACOs have strong incentives to adopt advance care planning (ACP) for long-term success, one out of five ACOs have few or no end-of-life processes in place. Although ACP can be difficult to coordinate across various care settings, there are processes that…
