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RECORDED WEBINAR: Preparing for Risk: Intersection of Compensation Design & Performance Improvement

February 25, 2021Garrett Schmitt

 Entering into any Value-Based contract changes the way you operate. With regards to physician compensation, expect to go well beyond the RVU model. Join Salient Healthcare and Sullivan Cotter in discussing compensation design and planning, performance management and design, and the optimization of timing with performance management. Speakers: – Maria Nikol, Sr. Business Consultant…

FLASH INTERVIEW — InfoMC, February 2021

February 23, 2021Garrett Schmitt

 InfoMC’s care coordination and care management platform helps Care Coordinators and Care Managers engage patients in their care plans and easily connect them to community-based and other resources to address SDoH needs. Our solution uses a person-centered, integrated approach that promotes quality, efficient and effective care and enables patients and Care Teams to work…

The digital divide becomes a new social determinant of health

February 22, 2021Garrett Schmitt

Telehealth and other connected health services are not the silver lining to the pandemic that many people thought. Many patients can’t afford or don’t want the needed broadband connection, creating another obstacle for the underserved. In Orange County, Calif., when COVID-19 forced CalOptima to shut down its health and social care center, Elizabeth Lee, director…

Achieving Success in Medicare’s Highest-Risk ACO Program: One ACO’s Story

February 18, 2021Garrett Schmitt

The federal accountable care organization (ACO) landscape continues to twist and turn, with one of the most recent developments being the drop of participants in the Medicare Shared Savings Program (MSSP), down from a membership high of 561 in 2018 to 477 at the start of 2021. Leaders at the National Association of ACOs (NAACOS) assert that…

Coordinated payment policies could speed transition to value, experts say

February 17, 2021Garrett Schmitt

HHS needs to overhaul its approach to value-based payment to ensure widespread practice transformation and rein in Medicare spending, according to a report by the Leonard Davis Institute of Health Economics at the University of Pennsylvania released Wednesday. Experts said the agency needs a new strategy because providers and payers have been too slow to adopt value-based…

Addressing Social Determinants Lowered ED Utilization in Medicare

February 17, 2021Garrett Schmitt

A CMS-run care delivery model focused on addressing social determinants of health has effectively identified higher cost and utilization patients while reducing potentially unnecessary emergency department (ED) visits, a new report shows. The Accountable Health Communities (AHC) Model reduced hospital ED visits by 9 percent for Medicare fee-for-service beneficiaries screened for health-related social needs, including housing instability,…

Low-Value Care Spending Slows as Medicare Pushes Value-Based Care

February 17, 2021Garrett Schmitt

Low-value care spending among fee-for-service Medicare recipients dropped slightly from 2014 to 2018. However, two of the three services that make up the majority of low-value healthcare spending, antibiotic and opioid prescriptions, increased despite a national campaign to promote value-based care, according to a new RAND Corporation study. The researchers analyzed healthcare data of more than…

How to bring specialists into the ACO fold: 9 strategies for success

February 11, 2021Garrett Schmitt

Although specialty care drives 40% to 60% of medical costs, specialists are often disconnected from accountable care organizations. Their fee and incentive structures are distinct, and too many care management systems don’t try to bring specialists into the fold. Specialists, however, are critical to care delivery—and they should be viewed as care partners and not…

Next Gen ACOs: Savers or Spenders?

February 11, 2021Garrett Schmitt

The Next Generation ACO program, was supposed to end in 2020, but it was granted a one-year reprieve because of the COVID-19 pandemic. The National Association of ACOs (NAACOS) wants that extension to become permanent and says the “Next Gen” ACOs save the Medicare program a lot of money. Former CMS Administrator Seema Verma begs…

CMS Regulation Impacts on MSSP and QPP: The Top 10 Changes ACOs Need to Know

February 11, 2021Garrett Schmitt

ACOs participating in shared savings programs face a number of opposing forces in 2021. From a decline in the number of Medicare beneficiaries to new CMS regulations to force downside risk sooner, ACOs are carefully weighing their options in the year ahead. In fact, the number of ACOs participating in the Medicare Shared Savings Program…

CMMI’s geographic direct contracting model needs an overhaul, experts say

February 10, 2021Garrett Schmitt

Consumer advocates, accountable care organizations and several experts think CMS’ Center for Medicare & Medicaid Innovation should delay its Geographic Direct Contracting model—dubbed “Geo”—until it resolves a number of issues that could create significant confusion among Medicare beneficiaries and operational and financial challenges for providers. The model builds on the lessons learned from the Medicare…

7 New Value-Based Health Care Directions You’ll See In 2021

February 10, 2021Garrett Schmitt

Everyone who’s reeling from 2020 is hoping for light in 2021. Health care, especially—systems, hospitals, clinical practices and their providers—wants the pain to stop. What might lie ahead for health care next year? Here’s what we’re thinking about the near future, and what you should watch for in 2021. 1. Health care providers will be…

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