March 27, 2024 - The Merit-Based Incentive Payment System (MIPS) is a mandatory quality payment system for clinicians who receive Medicare Part B payments unless they qualify for an exception or are part of an alternative payment model (APM). More than 655,000 eligible clinicians engaged with the MIPS program in 2021, according to the latest data from CMS.
The...
Primary care is arguably the most critical component of our healthcare system. Primary care and preventive medicine can help avert and manage chronic diseases and prevent long-term complications.
However, efforts to improve primary care...
CMS has announced a new Medicaid payment model that will incent care coordination across physical, behavioral, and social providers to improve the quality of care Medicare and Medicaid beneficiaries...
The CMS Comprehensive Primary Care Plus (CPC+) model was not associated with reduced healthcare expenditures or care quality improvements, a study published in JAMA found.
CMS launched the five-year...
Thirty-day mortality rates were higher for acute myocardial infarction and pneumonia at hospitals with higher shares of Black patients, suggesting that Medicare’s Hospital Value-Based...
The Centers for Medicare and Medicaid Services (CMS) aims to have all traditional Medicare beneficiaries under a value-based care model by 2030.
Although the pace may be slow, the healthcare industry is shifting away from fee-for-service...
Healthcare organizations are becoming more familiar with value-based care, but opportunities remain to improve and expand upon the care delivery model, according to a survey conducted by Sage Growth...
The healthcare payment process is undergoing a dramatic transformation as payers and providers shift from volume to value. While stakeholders are currently piloting many value-based care models, accountable care organizations (ACOs) are...
More provider organizations are participating in value-based contracts outside Medicare, as three-quarters of respondents were under contracts with commercial and Medicare Advantage plans in 2022, a...
Over half of healthcare payments last year were made through value-based reimbursement models, with most of those payments tied to some degree of financial risk, according to the latest data from the Health Care Payment & Learning...
As its name states, the Vermont All-Payer Accountable Care Organization (ACO) Model is an arrangement that incorporates patients with both private and public healthcare coverage, but what makes this model so appealing to providers? Is this...
The Medicare Shared Savings Program (MSSP) saved Medicare $1.8 billion in 2022, with 63 percent of accountable care organizations (ACOs) earning payments for their performance.
This is the sixth...
CMS has announced plans to test an alternative payment model (APM) to support Medicare beneficiaries with dementia and their unpaid caregivers.
The Guiding an Improved Dementia Experience (GUIDE)...
Hospitals with more medically complex patients, uncompensated care, and patients who live alone are more likely to receive a penalty under CMS value-based payment programs, according to a new study...
If the Hospital Value-Based Purchasing (HVBP) program value weights were based on Medicare beneficiary preferences, nearly $86 million in payment incentives would be reallocated and smaller rural...
Quality reporting is now a core function in healthcare, enabling value-based payment, transparency and accountability, and provider comparisons, to name a few benefits. However, quality data...
Lawmakers have their eyes on pharmacy benefit manager (PBM) reform, but one bill is looking to take it a step further by requiring commercial payers to share pharmacy claims data with providers to...
Value-based care participation is lacking among primary care physicians; most practices reported receiving fee-for-service payments in 2022, according to data from the Commonwealth Fund.
Value-based...
The National Association of ACOs (NAACOS) is calling on CMS to establish a hybrid primary care payment model in the Medicare Shared Savings Program (MSSP) using two possible approaches that will...
Despite the notion that social risk adjustment may improve health equity in value-based payment models, incorporating community-level social risk factors into Medicare risk adjustment did little to...