Value-based Reimbursement

PCPs Paid Under Global Capitation Deliver Higher Quality Care

by Jacqueline LaPointe

Global capitation payments provide strong incentives for primary care physicians to achieve key quality metrics, including cancer screening and medication review, UnitedHealth Group concluded from new...

Some Alternative Payment Models Are Improving Behavioral Health

by Jacqueline LaPointe

Alternative payment models (APMs) are taking steps to improve behavioral health, but the models need more to make large strides, according to a study from the University of Washington and Harvard...

Lawmakers Propose Changes to MACRA to Boost ACO, APM Participation

by Jacqueline LaPointe

A bipartisan bill introduced late last week aims to increase alternative payment model (APM) participation by making “commonsense changes” to the Medicare Access and CHIP Reauthorization...

Value-Based Incentives Didn’t Reduce Hospital-Acquired Infections

by Jacqueline LaPointe

Two of Medicare’s value-based incentive programs did not improve the levels or trends of certain hospital-acquired infections, potentially widening the gap between safety-net and non-safety-net...

Standalone ACOs Saved More Than Hybrid Medical Home Models

by Jacqueline LaPointe

Accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) both saved money compared to standard care, but combining the alternative payment and care delivery models did not lead...

CMS: Value-Based Reimbursement Key to Addressing Health Disparities

by Jacqueline LaPointe

Article updated 06/24/2020 to include a statement from the National Association of ACOs. Health disparities proven by Medicare claims data during the COVID-19 crisis underscore the need to transition...

How Value-Based Payments Support Physicians During a Crisis

by Jacqueline LaPointe

More practices are going to want to get their revenue through value-based payments following the COVID-19 pandemic, according to heart failure cardiologist Sanjay Doddamani, MD. The pandemic has shown...

ACOs Can Grow Value-Based Payment in Medicare, But Changes Needed

by Jacqueline LaPointe

With Medicare spending growing at an unsustainable rate, the Medicare Payment Advisory Commission is advising Congress to accelerate the transition to value-based payment, using accountable care...

Coronavirus May Reshape Investment, Value-Based Reimbursement

by Emily Sokol, MPH

Investment strategies and value-based reimbursement models will change as organizations continue to combat the coronavirus and move towards the future, according to insights from the Value-Based Care...

CareMount’s Foundation for Accountable Care Organization Savings

by Jacqueline LaPointe

In CareMount Health Solutions’ first year as an accountable care organization (ACO) in Medicare’s Next Generation ACO Model, the organization was one of 38 participants to earn shared...

CMS Extends Next Generation ACO Model, Offers APM Flexibilities

by Jacqueline LaPointe

As healthcare providers continue to respond to the COVID-19 crisis, CMS is granting key flexibilities to participants in alternative payment models (APMs) managed by the agency’s Innovation...

More Physician Groups Lead Accountable Care Organizations

by Jacqueline LaPointe

There were more physician-led accountable care organizations (ACOs) than hospital-led ACOs by 2018, according to a study from Leavitt Partners. Physician-led ACOs accounted for approximately 45...

Providers in APMs Had Head Start with Managing COVID-19 Surge

by Jacqueline LaPointe

Healthcare providers participating in alternative payment models leveraged their value-based care capabilities to safely manage the COVID-19 crisis, a new survey showed. For more coronavirus updates,...

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...

Providers Say Cost Transparency Will Improve Value-Based Care

by Emily Sokol, MPH

As the healthcare industry continues to move towards value-based reimbursement, providers are calling for increased cost transparency to succeed in these models. Earlier work from Insights...

Over Half of At-Risk ACOs May Quit MSSP to Avoid COVID-19 Losses

by Jacqueline LaPointe

More than half (56 percent) of accountable care organizations (ACOs) taking on downside risk through the Medicare Shared Savings Program (MSSP) are considering exiting the program due to concerns that...

Healthcare Reimbursement Still Largely Fee-for-Service Driven

by Emily Sokol, MPH

Value-based reimbursement is frequently cited as healthcare’s silver bullet. Changing the way providers are incentivized to deliver care can alter care delivery, placing the focus on...

CMS Relaxes Quality Reporting for Value-Based Purchasing Models

by Jacqueline LaPointe

Providers participating in some of Medicare’s largest value-based purchasing models will have some flexibility with quality reporting due to the ongoing COVID-19 pandemic, CMS announced last...

Third of Execs Don’t Think Value-Based Payment Will Usurp FFS

by Jacqueline LaPointe

Value-based payment adoption has steadily increased, but a third of healthcare executives in a new survey do not believe the alternative payment mechanism will usurp fee-for-service. Fee-for-service...