Value-Based Contracting

CMS Replaces Direct Contracting Model with New ACO REACH Model

by Victoria Bailey

CMS has overhauled the Global and Professional Direct Contracting model and announced the ACO Realizing Equity, Access, and Community Health (REACH) model. The redesigned accountable care organization...

Former Obama Appointees Urge HHS, CMS to Continue Direct Contracting

by Victoria Bailey

A group of former appointees under the Obama administration are urging federal officials to preserve the Global and Professional Direct Contracting model, stating that the model helps accountable care...

NAACOS, APG Urge HHS to Adjust Direct Contracting Model, Not Cancel

by Victoria Bailey

More than 200 healthcare organizations, including America’s Physician Groups (APG) and the National Association of ACOs (NAACOS), have urged the Department of Health and Human Services (HHS) to...

Signify Health to Acquire Caravan Health, Further Value-Based Care

by Victoria Bailey

Value-based care platform Signify Health has signed an agreement to acquire Caravan Health and aims to increase participation in value-based payment models and improve patient outcomes. The merger...

Physician Compensation Still Hinges on Volume at System-Owned Practices

by Jacqueline LaPointe

Despite a decades-long push toward value-based payment, physician compensation arrangements at health system-owned practices still primarily revolves around the volume of services delivered, according...

The State of Value-Based Reimbursement, Financial Risk in Healthcare

by Jacqueline LaPointe

Most healthcare payments made in 2020 were tied in some way to value or quality of care, according to the latest data from the Health Care Payment Learning & Action Network (LAN). The LAN’s latest APM Measurement report showed...

How Providence Is Overcoming a Top Value-Based Care Challenge

by Jacqueline LaPointe

Providence St. Joseph Health has been at the forefront of delivering high-quality, affordable care to patients. Value-based care is a vital pillar of the health system’s strategic plan for transforming care to improve outcomes and...

CMS Lays Out New Strategy for Advancing Value-Based Care, APMs

by Jacqueline LaPointe

The delivery and payment of care will look a lot different by 2030, according to CMS. The federal agency has announced that it expects all Medicare beneficiaries with Parts A and B to be in a care...

What It Takes for Medicare ACOs to Earn Shared Savings

by Jacqueline LaPointe

The majority of accountable care organizations (ACOs) participating in the Medicare Shared Savings Program earned shared savings last year despite dealing with a global pandemic that altered healthcare...

Key Characteristics for Successful Downside Risk Contracting

by Erin McNemar, MPA

Organizations that do strong vendor relationships, invest in the organization, and are willing to take on commercial risk will be poised to take on downside risk financial contracts. Through working...

Surgical Costs, Complications Slowed Under MD’s All-Payer Model

by Jacqueline LaPointe

An all-payer model that puts caps on hospital spending has slowed surgical spending and the rate of avoidable complications across major surgical procedures, according to a recent study published in...

Lessons Learned from Aetna, Cleveland Clinic’s Joint ACO Model

by Jacqueline LaPointe

In August 2020, Aetna and Cleveland Clinic announced an innovative product for employers in Northeast Ohio. The two leading healthcare organizations partnered to form an accountable care organization...

Primary Care Faces Existential Threat Over Healthcare Workforce Woes

by Jacqueline LaPointe

Clinician burnout, lay-offs, and other healthcare workforce challenges coming out of the COVID-19 pandemic are creating issues for primary care, according to a new survey. About 40 percent of over 700...

Number of Accountable Care Organizations Declined During COVID-19

by Jacqueline LaPointe

Accountable care organization (ACO) growth has hit a snag again, with the COVID-19 pandemic impacting the number of ACOs in public and private contracts, according to a new analysis. The analysis...

MedPAC to HHS: Reduce Number of Alternative Payment Models

by Jacqueline LaPointe

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...

Value-Based Contracting 101: Preparing, Negotiating, and Succeeding

by Jacqueline LaPointe

The Triple Aim. The Quadruple Aim. Right care at the right place at the right time. Whether one works in a hospital or small independent practice, healthcare providers are leaning on these concepts to deliver valuable care to their...

Remote Patient Monitoring, Telehealth Support Value-Based Contracts

by Jacqueline LaPointe

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...

Providers Want Another Shot at Applying for Direct Contracting

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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

by Jacqueline LaPointe

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...