RECORDED WEBINAR: Alignment & Parity Among MSSP & MA Payment Models: Preparing Providers to Better Manage Beneficiaries Through Contract Alignment

Garrett SchmittNo Comments, , , ,

 Download Slides What will be covered in this presentation: Current state of value-based payment models Similarities and differences across Medicare Advantage and Medicare patient populations, attribution methods, payment mechanisms, quality metrics, post-acute care pathways, and other concepts for contract negotiation Required resources and infrastructure for maintenance and management. Visit Salient Healthcare Booth

RECORDED WEBINAR: How to Determine Your ACO’s Readiness to Move Toward Risk

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 Download Slides As provider organizations prepare for Pathways to Success and determine their best approaches for aligning with CMS’s accelerated risk path, ACO’s have important decisions to make in order to ensure their success under CMS’s value-based initiatives, including how to: – Determine the right performance track and when to select it – Find…

RECORDED WEBINAR: Leveraging ACO Waivers – An Investment Opportunity for Physician Led ACOs

Garrett SchmittNo Comments, , , , , , , , , ,

 Download Slides  Has your Medicare Shared Savings Program (MSSP) ACO taken full advantage of the many waivers of federal fraud and abuse laws, such as the Stark Law and the Anti-Kickback Statute? During the webinar we will discuss the different types of waivers, what they are, which ones matter to you, how to use…

The Case For Downside Risk (Or Not)

Garrett SchmittNo Comments, , , ,

Many payers, most notably the Centers for Medicare and Medicaid Services (CMS), have developed new payment models that base reimbursement on a broader bundle of services than traditional fee-for-service payment. The accountable care organization (ACO) program exemplifies the broadest of these new payment models. One of the crucial ACO design features is the extent to…

RECORDED WEBINAR: Risk Adjustment Coding & Its Impact on ACO Performance

Garrett SchmittNo Comments, , , , , , , , ,

Download Slides  Each year, CMS sets cost benchmarks for every Medicare member based on the patients’ demographics and diagnoses during the assessment period. But what if the physician didn’t report their patients’ diagnoses accurately or specifically? The result is often benchmarks that are set appropriately low based on the information provided by the physician, and…

‘A’ is for Accountable

Garrett SchmittNo Comments,

Accountable care organizations (ACOs) cannot, and should not, hide from downside risk. Despite the ongoing kerfuffle between CMS’s (Centers for Medicare and Medicaid Services) push for downside risk and the threat of mass exodus by early ACO adopters, downside risk is proving fruitful and gaining momentum. Admittedly, ACOs have legitimate reasons for hesitating. In addition…

Should CMS Push ACOs Into Two-Sided Risk?: Part I

Garrett SchmittNo Comments, , , , ,

The Medicare Shared Savings Program (MSSP), now in its sixth full performance year, is at a significant crossroads. In creating the MSSP, Congress envisioned that Medicare accountable care organizations (ACOs) could moderate Medicare spending and improve quality of care by providers taking greater responsibility for costs and quality. While MSSP ACOs have clearly improved the…

Key Issues Impacting Two-Sided Risk Accountable Care Organizations

Garrett SchmittNo Comments, , , , , , ,

Medicare accountable care organizations (ACOs) operating under two-sided financial risk arrangements save the federal healthcare program more than one-sided risk organizations. But policymakers must address financial incentives, benchmarks, and other issues to ensure two-sided risk ACOs continue to generate savings, the Medicare Payment Advisory Commission (MedPAC) recently reported. “Medicare ACOs were created to help moderate…

 
Key Issues Impacting Two-Sided Risk Accountable Care Organizations