Value-Based Care News

Consumer Advocacy Orgs Share How to Move Away From Fee-For-Service Payment

March 1, 2024 - As healthcare spending rises, shifting away from fee-for-service payment and delivery models that incentivize volume over value is imperative. Families USA and other consumer advocacy groups are urging policymakers to implement reforms that improve healthcare affordability and quality and support the transition to value-based care. Families USA,...


Articles

Making ACOs More Accessible for Long-Term and Post-Acute Care Providers

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The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) and the National Association of ACOs (NAACOS) have released recommendations on how to increase accountable care...

HAC Reduction Program Penalizes Safety-Net Hospitals At Higher Rates

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Despite recent methodology changes, teaching and safety-net hospitals continue to be more frequently penalized in the Hospital-Acquired Condition Reduction Program (HACRP), a study published in JAMA...

After Slowdown, ACO Participation in Shared Savings Program Grows

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More accountable care organizations (ACOs) are participating in Medicare programs this year, including a new, permanent payment option in the Shared Savings Program. CMS recently announced ACO...

New Medicaid Payment Model Targets Behavioral Health Integration

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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...

Primary Care Model Did Not Reduce Healthcare Spending or Improve Care

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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...

Does Medicare Value-Based Purchasing Exacerbate Racial Care Disparities?

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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...

NY Healthcare Orgs Collab to Deliver Value-Based Hospice, Palliative Care

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Bassett Healthcare Network, a New York-based health system, has partnered with Helios Care to provide patients with value-based hospice and palliative care. Patients in five counties across Central...

CMS Model Aims to Improve Maternal Health Outcomes, Access to Care

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CMS has launched a new care delivery model to address maternal health outcomes and increase pregnancy and postpartum care access. The Transforming Maternal Health (TMaH) model will run for ten years...

Most Surgeons Earned MIPS Bonus Payments in 2021, Study Finds

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Most surgical healthcare professionals participating in the Merit-based Incentive Payment System (MIPS) earned bonus payments in 2021, with urologists seeing the highest adjustment, a study published...

Despite Value-Based Care Growth, Room for Improvement Remains

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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...

More Provider Orgs Have Value-Based Contracts With Private Payers

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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...

Value-Based Payments in Medicaid Tied to More Behavioral Health Visits

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Medicaid value-based payment reform was associated with an increase in behavioral health visits for patients with mental health conditions, a study published in JAMA Health Forum found. As of 2020, 12...

NAACOS: Medicare Payment Incentives Favor Clinicians in Fee-For-Service

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Medicare payment incentives favor clinicians participating in fee-for-service models rather than those in advanced alternative payment models (APMs), according to the National Association of...

Medicare Shared Savings Program ACOs Saved $1.8B in 2022, CMS Reports

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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 Updates ACO REACH Model for 2024 to Improve Health Equity

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CMS has announced revisions to the ACO Realizing Equity, Access, and Community Health (ACO REACH) model to improve health equity and predictability for participants. CMS replaced the Direct...

CMS Will Test APM for Medicare Beneficiaries with Dementia, Caregivers

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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)...

AHIP, AMA, NAACOS Share Best Practices for Value-Based Care

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Healthcare organizations must focus on improving data-sharing practices to advance the adoption of value-based care arrangements, according to AHIP, the American Medical Association (AMA), and the...

NAACOS: Medicare Shared Savings Program Needs Full-Risk Option

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A full-risk option in the Medicare Shared Savings Program (MSSP) would offer accountable care organizations (ACOs) additional flexibility and more capitation options, according to the National...

Hospitals with Health Equity Factors Face Value-Based Penalties

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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...