Value-Based Care News

MedPAC to HHS: Reduce Number of Alternative Payment Models

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To advance value-based care, the Medicare Payment Advisory Commission (MedPAC) has suggested that HHS reduce its number of alternative payment models (APMs) now that it has lessons learned from a wide...

NIH Awards Grant to Study Effects of ACOs on Child Asthma Care

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The National Institutes of Health (NIH) awarded a $3 million grant to Sarah Goff, MD, PhD, a health services researcher at the University of Massachusetts Amherst, to study the effects of accountable...

“Soft” Consolidation in Medicare ACOs Can Lead to Higher Prices

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Some independent primary care practices joining health system-led Medicare accountable care organizations (ACOs) raised their prices after what researchers called “soft consolidation,”...

CJR Model Linked to Increased Health Disparities, Study Reveals

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In a study of over four million Medicare beneficiaries, researchers found that the Comprehensive Care for Joint Replacement (CJR) model may be widening racial and socioeconomic health disparities in...

Community Health Workers Help to Drop Hospital Readmission Rates

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The Community Care Transitions (C-CAT) clinical trial, recently published in JAMA Network Open, matched Massachusetts General Hospital (MGH) patients insured by accountable care organizations with...

Spike in Radiologist Accountable Care Organization Participation

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Radiologist involvement in Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) has increased significantly in recent years, showing promise for increased specialist...

CMS to Reweight MIPS Cost Performance Category for 2020

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CMS announced it will be reweighting the cost performance category under the Merit-Based Incentive Payment System (MIPS) from 15 percent to zero percent for the 2020 performance period to provide...

Remote Patient Monitoring, Telehealth Support Value-Based Contracts

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The COVID-19 pandemic has blown the doors wide open on telehealth, especially with new reimbursement parity policies. But value-based contracts can support the growing interest in remote patient...

No Extension for Next Generation ACO Model After This Year

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The Next Generation Accountable Care Organization (ACO) Model will come to an end at the end of this year as planned despite several calls for an extension, according to an email to model...

Healthcare Payment Reform is Critical to Improving Primary Care

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High-quality primary care implementation requires significant healthcare payment reform, expanded telehealth capabilities, and team-based care, according to a recent report from the National...

What Drives Value in the Merit-Based Incentive Payment System?

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In a recent survey, physicians were asked if and how the four evaluation components of the Merit-based Incentive Payment System (MIPS)—quality, promoting interoperability, improvement...

Medical Groups Ask for More Time Before ACO Quality Reporting Changes

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According to nearly a dozen leading medical groups, changes to accountable care organization (ACO) quality reporting are rushed, unclear, and potentially harmful to patient care. In a letter to HHS...

Home Discharge Program Prevents Hospital Readmission For ED Patients

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An at-home discharge service piloted at Penn Medicine successfully prevented hospital readmission in nine out of 10 emergency department patients, according to a study published in Healthcare that...

Medicare FFS Claims Suggest Targeted Low-Value Care Interventions

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Hospitals that are for-profit, non-teaching, and/or located in the South administer the highest rates of low-value care among traditional Medicare beneficiaries, according to a new study published in...

Providers Want Another Shot at Applying for Direct Contracting

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Dozens of physician and hospital groups are seeking another opportunity to sign up for the new directing contracting model days after the CMS closed down applications for future cohorts. The agency...

How Fowler Plans to Refresh CMMI’s Value-Based Care Vision

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The healthcare system is at a critical point in its transition to value-based care a decade after implementation of the Affordable Care Act and its Center for Medicare and Medicaid Innovation (CMMI),...

Industry Groups Seek Next Gen Extension, Full-Risk ACO Options

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A group of leading healthcare industry groups are calling on HHS to provide more full-risk accountable care organization (ACO) model options, including an extension of the popular Next Generation ACO...

CMS Stops Accepting New Direct Contracting Applications

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CMS has announced that it will not be soliciting any more applications for the Global and Professional Direct Contracting Models slated to launch on January 1, 2022. Organizations that had already...

CMS Delays CHART Model’s ACO Transformation Track

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CMS has pushed back the application cycle by a year for a new rural-focused accountable care organization (ACO) model. In an email sent yesterday, CMS said it has delayed the request for applications...

Solving the ACO’s Out-of-Network Utilization Problem

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Physician networks are key to the success of accountable care organizations. Leaders of these organizations, otherwise known as ACOs, lean on their networks of high-quality, cost-efficient providers to...