Many providers are concerned about rising thresholds in Medicare ACOs, which could lead them to reconsider participation in value-based models, according to a new survey. The National Association of Accountable Care Organizations (NAACOs) surveyed 116 ACOs across a number of programs, and found that 90% were concerned they would be unable to reach qualifying thresholds in…
The federally appointed Physician-Focused Payment Model Technical Advisory Committee said Tuesday it has recommended HHS consider a payment model focused on asthma care. The payment model, if approved by HHS, would provide allergists, immunologists and pulmonologists a value-based payment option. A longstanding complaint of the movement to alternative payment models is it has excluded many specialists from…
COVID-19 has highlighted why access to timely and actionable public health data is critical for making quick, life-saving healthcare decisions. Which patient population segments are at a higher risk of mortality and which of these are getting needed preventive services? What regions in the country are flash points for COVID-19 resurgence? Are the Providers…
Over the last three years, under the Trump Administration, the Centers for Medicare & Medicaid Services (CMS) has been advancing innovative payment and service delivery models to help move our health care system from one that pays for volume to one that rewards providers for keeping patients healthy, improving health outcomes and lowering costs. A…
ACOs know that reducing costs is the key goal for Value-Based reimbursement. But strategies on how—or even whether—to engage physicians in that goal have not always been successful, to the detriment of all involved. Part of the problem is that provider revenues still stem from Fee-for-Service payments. Physicians are still rewarded based on meeting volume…
The Diabetes Eye Exam quality measure is commonly referred to as one of the most difficult care gaps to close. Since up to 50% of diabetic patients lack documentation of a retinal eye exam, ACOs and practices spend a significant amount of administrative time each year chasing charts to close this measure. At Topcon,…
The coronavirus pandemic highlighted the importance of value-based contracts and reimbursement and will continue to push the industry towards these models of care, according to healthcare stakeholder responses in Insights by Xtelligent Healthcare Media’s latest report. The Future of the Healthcare: Moving Beyond 2020 surveyed 363 healthcare industry leaders to understand their organization’s response to COVID-19, building…
Dive Brief: Clinicians who were affiliated with a health system had “significantly better” performance scores under the Merit-based Incentive Payment System than those who were unaffiliated, according to a JAMA study published Tuesday. The researchers noted, however, that the study does not determine whether affiliated physicians were providing better quality care, raising questions about the program’s…
Many other countries’ healthcare systems outperform ours for one simple reason: They place a much greater emphasis on primary care, which occupies the central place in their systems. “The evidence is that where you have more primary care physicians, where you coordinate care, and where you pay to keep people healthy, you get better outcomes…
Risk Strategies provides a full suite of risk management services to ACOs and their physicians including Specific and Aggregate Reinsurance, Surety Bonds as a repayment mechanism in lieu of a Letter of Credit, Medical Malpractice Insurance, Reinsurance Captives for risk sharing, as well as Managed Care E&O and D&O/EPL coverages. Risk Strategies is a…
