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…
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…
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…
Download Slides This is Part 2 of a two part series and was recorded on 6/19/2018. As with Part 1, this webinar will be informative for those considering taking risk in an ACO, specifically Track 1 ACOs considering moving to a risk-based model in 2019. What was covered in this session: The standoff between…
Download Slides Recorded on 6.5.18, this webinar will be informative for those considering taking risk in an ACO, specifically Track 1 ACO’s considering moving to a risk-based model in 2019. What is covered: Risk taking in the context of MACRA The move toward ACO risk: results & analysis Financial protection for your ACO View Part…
Most accountable care organizations say they will disband if the CMS forces them to take on financial risk next year. ACOs that started in the Medicare Shared Savings Program (MSSP) Track 1 in either 2012 and 2013 are supposed to move to a risk-based model by their third contract periods which begin next year, according…
Healthcare organizations have long employed various approaches to risk management to prepare for risks that are unique to healthcare delivery settings, such as adverse events that pose harm to patients, visitors, and employees. However, with the advent of the Affordable Care Act (ACA), which mandates the tethering of clinical and financial operations together into value-based…
Medicare Shared Savings Program (“MSSP”) Track 1+, Track 2 and Track 3 ACOs, 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, an ACO’s repayment mechanism equals 1% or 2% of the ACO’s total per capita Medicare…
State governments are experimenting with requirements and incentives for Medicaid accountable care organizations to address social determinants of health. Government executives say Medicaid ACO programs offer several key leverage points for addressing disparities and social determinants, including partnership and care management requirements, quality metrics and financial incentives. Here are some examples of efforts under way:…
