RECORDED WEBINAR: Managing the Unmanageable: Providers, Partners, and Patients

October 25, 2019Garrett SchmittNo CommentsACO, ACOs, Downside Risk, risk management, Webinar, webinars

 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

Can ACOs Survive the Complicated New Landscape in Medicare Risk?

July 25, 2019Garrett SchmittNo CommentsDownside Risk

What a difference a year makes. In Spring 2018, many Accountable Care Organizations (ACOs) pondered a walkout over Medicare plans that included downside risk in ACO financials. Nonetheless, CMS finalized its plans to make provider risk a reality for all ACOs in its Pathways to Success overhaul of the Medicare Shared Savings Program (MSSP). ACOs’ lukewarm reception…

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

July 17, 2019Garrett SchmittNo CommentsACO, ACOs, Downside Risk, Webinar, webinars

 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

June 11, 2019Garrett SchmittNo CommentsACO, ACOs, Downside Risk, risk management, Webinar, webinars

 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

May 14, 2019Garrett SchmittNo CommentsACO, ACOs, APM, Downside Risk, MACRA, Reinsurance, risk management, Risk Strategies, Surety Bonds, Webinar, webinars

 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…

ACO Repayment Mechanisms – Surety Bonds

February 8, 2019Garrett SchmittNo CommentsDownside Risk, Reinsurance, Surety Bonds

ACO Repayment Mechanisms – Surety Bonds Medicare Shared Savings Program (“MSSP”) Tracks 1+, 2, and 3; Pathways to Success Tracks C, D, E, and Enhanced; and NextGen ACOs, have two-sided risk. CMS requires these ACOs to provide a repayment mechanism to assure that shared losses can be repaid. Depending on its track, a Pathways to…

Risky business: 5 provider strategies to take on downside risk

October 24, 2018Garrett SchmittNo CommentsDownside Risk

Alternative payment models have been en vogue in American healthcare for some time now. Payers and providers are increasingly being asked to take on greater financial risk instead of shared savings alone. The latest data out this week shows that 34% of total U.S. healthcare payments were tied to APMs in 2017, up 12% from two…

The Case For Downside Risk (Or Not)

October 16, 2018Garrett SchmittNo CommentsAPM, APMs, Downside Risk, Pathways to Success, Risk

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

September 25, 2018Garrett SchmittNo CommentsACO, ACOs, Coding, Continuum Health, Downside Risk, Risk adjustment coding, Risk coding, risk management, Webinar, webinars

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

August 21, 2018Garrett SchmittNo CommentsDownside Risk, Risk

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…

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