Value-Based Care News

Making APMs Truly Value-Based Through Person-Centered Care

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Each stakeholder brings their own definition of value to the table when developing alternative payment models, which incent providers through value-based payments to deliver care that aligns with the...

Balancing Specialty and Primary Care Lowers Costs for ACOs

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Accountable care organizations (ACOs) that provided between 40 and 45 percent of office visits through specialists had significantly lower costs compared to ACOs with the lowest and highest specialty...

OIG Identifies What Makes Accountable Care Organizations Successful

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Accountable care organizations (ACOs) have reduced Medicare spending and improved care quality, but some organizations are doing it better than others, the HHS Office of the Inspector General (OIG)...

Oncology Practices Oppose Mandatory Bundled Payment Model

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Implementing a mandatory bundled payment model for radiation oncology oversteps CMS authority and could potentially harm cancer patients, the Community Oncology Alliance (COA) stated in response to a...

Advanced APM Participation Almost Doubled from 2017 to 2018

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Advanced Alternative Payment Model (APM) participation in the Quality Payment Program (QPP) nearly doubled from 2017 to 2018, increasing from 99,076 to 183,306 clinicians, CMS recently reported in an...

HHS Quality Summit to Examine Federal Value-Based Care Programs

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HHS recently announced the creation of the Quality Summit, which will bring together federal and private healthcare stakeholders to evaluate and streamline federal value-based care programs. The...

Joint Replacement Bundled Payments Save Nearly $1K Per Episode

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Hospitals participating in a joint replacement bundled payments model through Medicare saved $997 per episode during the first two performance periods, according to a second annual report on the model...

Value-Based Payment Reform Key to Moving Forward with Value

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Value-based payment reform will be the key to lowering healthcare costs and improving care quality, according to health economist Michael Chernew, PhD. At AHIP’s 2019 Institute & Expo in...

What Makes an Alternative Payment Model Successful

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The healthcare industry is moving beyond just the development and adoption of alternative payment models (APMs), according to Aparna Higgins, a former leader at the Health Care Payment Learning and...

Cigna CEO: Healthcare Consumer Experience Key to Transformation

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NASHVILLE - Enhancing the healthcare consumer experience is the task currently in front of healthcare payers and providers, according to David M. Cordani, president and CEO of Cigna...

COA Proposes New Oncology Care Model with Value-Based Purchasing

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The Community Oncology Alliance (COA) recently submitted an alternative payment model proposal to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) that builds on the work done by...

AMA Seeks Alternative Payment Models for Vulnerable Populations

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In an effort to reduce healthcare disparities, the American Medical Association (AMA) recently vowed to support the creation of new alternative payment models that specifically address the outcomes of...

Accountable Care Organizations Lower Costs Compared to HMOs, PPOs

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Commercial accountable care organizations (ACOs) in California are outperforming two common provider network arrangements in terms of care quality and total cost of care, according to a recent analysis...

Provider Groups Want to Make Next Generation ACOs Permanent

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Leading provider groups are asking HHS to make the Next Generation accountable care organization (ACO) model a permanent part of Medicare’s largest ACO program: the Medicare Shared Savings...

As MACRA Implementation Turns 2, Industry Leaders Call for Change

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For the past two years, MACRA has been shifting providers away from fee-for-service to value. But industry leaders still have reservations about MACRA implementation and the law’s value-based...

Medicaid ACO Growth Still Lags Behind Medicare, Commercial Payers

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Medicaid accountable care organizations (ACOs) have not grown as quickly as industry experts anticipated, according to a new report from Leavitt Partners. ACOs with at least one Medicaid contract...

CPC+ Did Not Cut Medicare Spending, Improve Quality in First Year

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The Comprehensive Primary Care Plus (CPC+) did not affect total Medicare spending, and the value-based reimbursement program for primary care practices had little impact on service use and care...

Exploring Value-Based Payment Models Under Primary Care First

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On April 22, 2019, HHS unveiled the Primary Cares Initiative, a program that aims to reduce administrative burdens and enable primary care providers to focus more time on patients while decreasing...

Providers, Execs Applaud Medicare’s Primary Cares Initiative

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Provider groups and healthcare executives are on board with Medicare’s new Primary Cares Initiative, which will shift primary care from fee-for-service to at-risk value-based reimbursement models...

48 States Running Value-Based Reimbursement, Care Initiatives

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Forty-eight states have implemented value-based reimbursement or care programs as of February 2019, representing a seven-fold increase compared to five years ago, a new Change Healthcare study...