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…
Consumers are rapidly becoming aware that costs for health care coverage extend well beyond premiums, copays, and deductibles—costs such as additional charges for out-of-network physicians and facilities. There is also a growing understanding that different providers charge varying costs for services—and that other hidden variables can increase the final bill for treatment. But consumer health…
One of the well-attended panel sessions at the Fall 2019 meeting of the National Association of ACOs (NAACOS) was called “Mastering Chaos: Achieving High Quality of Care in Multi-TIN/Multi-EHR ACOs.” Like the expert panelists at the Washington, D.C., conference, Tom Boggs, president of Bridges Health Partners, knows a thing or two about overcoming the complexity…
The Centers for Medicare and Medicaid Services (CMS) recently announced that Accountable Care Organizations (ACOs) saved Medicare $739.4 million in 2018, up from $314 million in savings the year before. Those savings were achieved despite policies that Rooke-Ley and colleagues argue in a recent Health Affairs Blog post disadvantage ACOs relative to Medicare Advantage (MA) plans. Their analysis concludes that ACOs cut costs…
One of the most significant drivers of complex and expensive health problems is the high exposure to Adverse Childhood Experiences (ACEs). This fact can be troubling for ACOs that have taken on risk for the health of patients. Preventing and mitigating the impact of ACEs is a big stretch from providing clinical care. Minimizing ACEs…
CMS announced that Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program generated net savings of $739.4 million last year, and data suggests that physician-led ACOs continued to perform better than hospital-led ACOs. The savings came from 548 ACOs, which served around 10.1 million Medicare beneficiaries last year. Of these, 66 percent generated…
Most ASCs aren’t involved in ACO or joint venture care models and don’t plan to be, according to OR Manager‘s 2019 Salary/Career Survey. OR Manager collected data from 196 ASC leaders from March 28 to May 31. Respondents were either OR Manager subscribers or part of an external list. Three findings: 1. The following care models haven’t been adopted…
One worry about accountable care organizations (ACOs) is that their growth would lead to the consolidation of physician practices. A new study finds that concern has proven real. Researchers examined changes in physician practice sizes associated with ACO market penetration three years after the launch of the Medicare Shared Savings Program, which began in 2012 and…
Support for telehealth is breaking political barriers in the nation’s Capitol. In a bipartisan, bicameral initiative, legislation to expand telehealth services through Medicare was introduced yesterday, led by U.S. Sen. Brian Schatz (D-Hawaii), with a companion bill presented to the House of Representatives. Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health…
Download Slides During this presentation we discuss these important steps to expanding behavioral Health Solutions in your ACO: Provide PCP access to mental health care team and psychiatry services Focus on screenings such as PQH-9, GAD-7, trauma and substance abuse Evidence-based process to reduce symptoms in 50% less time than traditional approach Deliver population-level…
Download Slides During this presentation is discussed how to better manage the more difficult individuals, and get the right people on the bus. How to identify providers that don’t fall in line Reconfiguring your network to manage partners that adversely affect ACO performance Strategies to manage difficult or un-cooperative patients Visit HealthEC Booth
