Value-Based Care News

More States Require Value-Based Reimbursement in Medicaid

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The number of states with Medicaid managed care requiring value-based reimbursement as part of the public healthcare program increased from 22 out of 39 states in 2017 to 28 out of 40 states by 2019, a...

Driven By Decline in Medicare Contracts, ACO Participation Dips

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The introduction of Pathways to Success may behind falling accountable care organization (ACO) participation numbers, according to researchers from Leavitt Partners and the Duke-Margolis Center for...

HHS Endorses Alternative Payment Model for Emergency Medicine

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ACEP, an association representing 40,000 emergency physician members, developed and submitted the Acute Unscheduled Care Model (AUCM) to HHS’ Physician-Focused Payment Model Technical Advisory...

Physician-Led ACOs Saved More Than Hospital ACOs in 2018

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Physician-led accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) produced nearly seven times the savings per beneficiary than hospital-led ACOs, a new analysis...

Advocate Aurora Invests in People, Infrastructure for ACO Success

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Accountable care organization (ACO) success was no stranger to physicians at Advocate Health Care and Aurora Health Care. Now that the two major health systems are combined, the new...

CMS Says Clinicians to Receive Advanced APM Bonus Payments Soon

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In a fact sheet created on Sept. 27, CMS announced that Advanced Alternative Payment Model (APM) bonus payments for participation in an approved model in 2017 will be going out to qualifying clinicians...

Provider Incentives, M&A to Accelerate Value-Based Care Adoption

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Healthcare providers and other industry leaders are still facing significant challenges with value-based care adoption, but provider incentives and market consolidation could help accelerate the...

Medicare Shared Savings Program ACOs Saved $739M in 2018

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Accountable care organization (ACOs) in the Medicare Shared Savings Program saved $739.4 million in 2018 after accounting for shared savings and losses that year, according to program data released by...

Industry Group Ties Half of Business to Value-Based Payments

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Payer and provider members belonging to a group of leading healthcare stakeholders have increased the amount of business under value-based payments, even surpassing the 50 percent mark by the end of...

Stakeholders Criticize Payments, Measures in Mandatory ESRD Model

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Dialysis centers, major health systems, and other industry stakeholders are calling on CMS to reconsider a proposed end-stage renal disease (ESRD) model that will put providers at risk for at-home...

54% of Physicians Participate in an Accountable Care Organization

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The majority of physicians now participate in an accountable care organization (ACO), the American Medical Association (AMA) recently reported. Overall, 53.8 percent of physicians polled in September...

Providers Ask CMS Where Their 2019 Advanced APM Bonus Is

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More than 90,000 clinicians are still waiting on the 2019 Advanced Alternative Payment Model (APM) bonus payment for their participation in 2017 and nine industry groups are demanding payment from...

Stakeholders Pick Apart Bundled Payments for Radiation Oncology

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The American Hospital Association (AHA), Community Oncology Alliance (COA), and other key stakeholders voiced concerns about a mandatory bundled payments model for radiation oncology slated to take...

Improving Patient Outcomes Surpasses Reducing Cost as Top Priority

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A new survey from Johnson & Johnson Medical Devices Companies suggests health system clinicians and executives are moving beyond traditional cost cutting initiatives to address cost pressures and...

NY Medicaid Program Bringing Value-Based Payment to Pediatrics

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New York is overcoming the challenges of developing value-based payment models for pediatrics to bring value to the approximately 1.8 million children enrolled in its Medicaid program, according to a...

HHS Awards $107M to Health Centers for Low-Cost, Value-Based Care

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HHS recently awarded nearly $107 million to 1,273 health centers across the country to support quality improvement, as well as care efficiency and value-based care, according to an official...

ACOs Save More Compared to Medicare Advantage, Report Finds

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The Medicare Shared Savings Program, which governs the majority of Medicare accountable care organizations (ACOs), and Medicare Advantage are gaining in popularity. But the former is saving taxpayers,...

Hospital Revisits Increased Under Hospital Readmissions Program

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While hospital readmissions for targeted diseases fell under Medicare’s Hospital Readmission Reduction Program (HRRP), total hospital revisits within 30 days of discharge increased following...

Medical Groups Call for Value-Based Care Reforms to Reduce Burden

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Operating with one foot in fee-for-service and the other in value-based care has created significant administrative burdens for providers, so medical groups are now offering CMS value-based care...

Value-Based Care Necessitates Shift in Primary Care Staffing Model

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The medical assistant-only model for primary care staffing may be the most cost-effective for practices relying on fee-for-service revenue, but the model will not be able to support value-based care...