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

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…

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…

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

July 16, 2018Garrett SchmittNo CommentsCMS, Downside Risk, MedPAC, Regulation, Risk, risk management

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…

RECORDED WEBINAR: Transitioning Into a Successful Risk-Based ACO – Part 2: How to Prepare For Risk

June 19, 2018Garrett SchmittNo CommentsACO, ACOs, APM, Downside Risk, MACRA, Reinsurance, risk management, Risk Strategies, Surety Bonds, Webinar, webinars

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…

RECORDED WEBINAR: Transitioning Into a Successful Risk Based ACO Part 1: Why Move to Risk & How to Protect Your ACO

June 5, 2018Garrett SchmittNo CommentsACO, ACOs, APM, Downside Risk, MACRA, Reinsurance, risk management, Risk Strategies, Surety Bonds, Webinar, webinars

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…

Many Medicare ACOs Would Quit Rather Than Face Risk Next Year

May 2, 2018Garrett SchmittNo CommentsDownside Risk, MSSP, MSSPs, NAACOS, Risk, risk management

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…

Building an ERM Framework for Value-Focused Health Care

April 1, 2018Garrett SchmittNo Commentsenterprise risk management, ERM, Risk, risk management

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…

ACO Repayment Mechanisms – Surety Bonds

March 23, 2018Garrett SchmittNo CommentsDownside Risk, Reinsurance, risk management, Surety Bonds

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…

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