Risk Management

Medical Liability Premium Increase Draws Practice Viability Concern

by Hannah Nelson

Medical liability insurance premiums have begun an upwards trend after remaining relatively steady over the past ten years, according to a new American Medical Association (AMA) analysis that...

Risk Stratification Of Bundled Payment Models Requires Clinical Data

by Hannah Nelson

Incorporating clinical data into risk stratification could improve the accuracy of CMS bundled payment models like the Oncology Care Model (OCM), according to a new Avalere analysis. The OCM is a...

CMS Announces A New Value-Based Direct Contracting Model

by Jacqueline LaPointe

A new direct contracting model from CMS will test whether a geographic-based approach to value-based care can improve quality of care while reducing costs for Medicaid beneficiaries in a specific...

51 Organizations Join New Direct Contracting Opportunity from CMS

by Jacqueline LaPointe

CMS recently announced that 51 organizations will take part in a new directing contracting opportunity that will test what the agency calls the “next evolution of risk-sharing...

Healthcare Providers Did Not Take On More Financial Risk in 2019

by Jacqueline LaPointe

Nearly half of healthcare executives said 10 percent or less of their organization’s revenue came from risk-based contracts in 2019 despite expectations that financial risk in healthcare would be...

ACO Participation Did Not Lower Care Access for Vulnerable Patients

by Jacqueline LaPointe

Physician groups did not reduce their share of vulnerable patients after joining an accountable care organization despite claims of the opposite, a new study from the Perelman School of Medicine...

ACOs Concerned Coronavirus to Impact Shared Savings, Losses

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the Medicare Shared Savings Program and other shared risk models are worried the novel coronavirus pandemic could leave them responsible for shared losses...

Practices in Oncology Care Model Ready to Assume Two-Sided Risk

by Samantha McGrail

Oncology practices participating in CMS’ Oncology Care Model (OCM) are willing to take on two-sided risk, according to a survey conducted by the Community Oncology Alliance (COA).  The...

AMGA: Advancing Value-Based Care Hinges on Claims Data Access

by Jacqueline LaPointe

AMGA (American Medical Group Association) recently sent a letter to Congress outlining what it views as 2020’s top priorities for medical groups and health systems. Chief among the group’s...

ACOs Enrolled in MSSP Assume Downside Risk as the Program Matures

by Samantha McGrail

More accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) have assumed downside risk as the program progresses, according to a new Avalere analysis. Most...

What the Latest ACO Numbers Mean for the Future of the MSSP

by Jacqueline LaPointe

Last week, CMS Administrator Seema Verma reported that CMS approved the applications for 53 new accountable care organizations (ACOs) to join the Medicare Shared Savings Program (MSSP) starting on Jan....

Number of MSSP ACOs Taking Downside Risk Doubles, CMS Reports

by Jacqueline LaPointe

The number of accountable care organizations (ACOs) in the overhauled Medicare Shared Savings Program (MSSP) assuming downside financial risk doubled from 93 ACOS at the start of 2019 to 192 at the...

Next Generation ACOs Saved Medicare Over $184M in 2018

by Jacqueline LaPointe

Next Generation accountable care organizations (ACOs) reduced spending by about 1.11 percent in 2018, returning more than $184 million to the Medicare Trust Funds, according to new program results from...

7 MI Providers Take on Shared Risk Payment Model with Blue Cross

by Samantha McGrail

Seven healthcare organizations in Michigan recently signed on to participate in a new shared-risk payment model with Blue Cross Blue Shield of Michigan that will hold the providers accountable for...

AMA Bolsters Healthcare Economics Training for Future Physicians

by Samantha McGrail

The American Medical Association (AMA) adopted a new policy calling on all medical schools and residency programs to include healthcare economics training related to the structure and financing of the...

Data, Clinical Champions Key to Risk-Based Payment Model Success

by Jacqueline LaPointe

Healthcare spending is unsustainable and risk-based payment models are one of the ways to address that problem. Neither of these concepts are new to the healthcare community and have been around for...

CMS Opens Apps for Kidney Care Model, Delays Primary Care First

by Jacqueline LaPointe

Late last week, CMS started to accept applications for two new alternative payment models focusing on kidney and primary care, with the latter now facing a delayed implementation. Both the Kidney Care...