Accountable care organizations participating in the Medicare Shared Savings Program have generated $1 billion in savings since their inception—leading the way in value-based care, according to a new report from data activation platform company, Innovaccer. For its report, titled, “State of the Union Report for Medicare ACOs,” Innovaccer used its proprietary algorithm to look at…
A patient’s racial or ethnic background could influence which emergency department (ED) an ambulance takes her to, causing a considerable hit on health disparities and health equity, according to new data published in JAMA Open Network. Health disparities, or inequities in patients’ abilities to achieve health or unequal disease burden, impact patients across the country. Depending on certain social…
In mid-July, the Centers for Medicare and Medicaid Services (CMS) released the latest number of accountable care organizations (ACOs) participating in the Medicare Shared Savings Program. This was the first opportunity for ACOs to apply to participate in CMS’s largest value-based payment program since the agency redesigned the program last year. Changes CMS calls “Pathways to Success”…
Burnout is a big and burgeoning problem in the United States. According to a recent Mayo Clinic report, it affects 28% of the general working population. Among physicians, however, the rate is markedly higher, ranging from 44% to 54% in most studies. More concerning are the consequences: Doctors who report burnout symptoms are twice as likely to commit a medical error….
BJC HealthCare is in the CMS’ flagship accountable care organization program and nine of its hospitals participate in the federal agency’s flagship bundled-payments program. Recently, the St. Louis-based not-for-profit health system learned that quite a few patients it treats under bundles are also attributed to its ACO. Before knowing that, it was tough to predict…
There’s a lot that goes into making an ACO successful. Not the least of which is choosing the best solutions to help ACOs achieve physician engagement. In that regard, our primary objective at ACOExhibitHall.com (ACOEH) is to help ACO decision makers find the best solutions available to meet their operational needs. A recent Medical Economics article…
In the emerging days of Value-Based Health Care (VBHC), “value” was defined by quality, cost, and experience of health care for patients—the “Triple Aim.” The movement’s initial defining goal: patients should be able to access high value health care services that improved outcomes, to get value for their dollars. Likewise, employers and other purchasers deserved similar value…
In today’s healthcare climate, providers are increasingly expected to collect and report on numerous data points to payers and CMS. Collecting the data isn’t necessarily an issue, but the task of deciphering which subsets of data to harness—and how—in order to improve both the patient experience and business results is emerging as an enormous challenge….
The CMS has alerted accountable care organizations participating in the Medicare Shared Savings Program that they have more time to comply with a new requirement to notify assigned beneficiaries that their physician participates in the program. The new requirement, which was originally slated to go into effect July 1, has been delayed to Oct. 1…
Value-based healthcare organizations are responsible for out-of-network costs when calculating risk scores, benchmarks, cost reduction as it relates to minimum shared savings rate (MSR) and health outcome improvement based on quality metric score, re-admission rates or gaps in care completion rates. So, it’s important… 2.5 Million Medicare Patients Our analysis of 2.5 million de-identified patients, indicated…
When asked why he robbed banks, Willie Sutton, the infamous US bank robber, responded “because that’s where the money is.” This quote is the inspiration for “Sutton’s Law,” which recommends prioritizing those diagnostic tests that are most likely to yield a definitive diagnosis and quickly lead to a treatment recommendation. While Sutton’s Law has been…
While there is a lot of literature written about the benefits of a transition of care management visit (TCM) for patients, practices, and ACOs, why aren’t more providers billing for these visits? Unfortunately, there are a number of challenges related to completing a successful TCM. Let’s explore the Top 5 challenges, followed by some key…
