Value-Based Care News

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...

How Beneficiary Preferences Can Impact Hospital VBP Payment Incentives

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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...

Study: Hospital Spends $5M Per Year on Quality Reporting

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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...

CMS Primary Care Model Provides Value-Based Path for Practices

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CMS will test a new primary care model in eight states with the hopes of improving patient care and increasing value-based opportunities for primary care organizations. The Making Care Primary (MCP)...

Most Practices Not Joining Enhancing Oncology Model, Survey Finds

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Most oncology practices are not planning to participate in the Enhancing Oncology Model (EOM), citing concerns about the risk arrangements and inadequate incentive payments, a survey from the Community...

Home Health Value-Based Purchasing Model Lowered Medicare Spending

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The Home Health Value-Based Purchasing (HHVBP) Model reduced Medicare spending by $1.38 billion and improved care quality during its first six years, according to a report from CMS. The CMS Innovation...

Community Service Navigation Helped Reduced Emergency Department Use

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The CMS Accountable Health Communities (AHC) Model reduced emergency department (ED) use for Medicare and Medicaid beneficiaries but did not help resolve health-related social needs (HRSNs) issues as...

AMGA: Pharmacy Claims Data Key to Value-Based Care Progress

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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...

Benchmark Regionalization in MSSP Disincentivized Higher-Spending ACOs

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After CMS began incorporating regional spending into accountable care organization (ACO) benchmarks in the Medicare Shared Savings Program (MSSP), more higher-spending ACOs exited the program, a study...

Less than Half of Primary Care Physicians Participate in Value-Based Care

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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...

Lower Clinical Spending Needed in BPCI-A Program to Avoid Losses

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Hospitals and physician groups participating in the Bundled Payments for Care Improvement Advanced (BPCI-A) program would have had to reduce clinical spending by 3.7 percent to 8.2 percent during the...

NAACOS Offers Guidance for Hybrid Primary Care Payment Model in MSSP

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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...

Community-Level Social Risk Adjustment Did Not Address Payment Disparities

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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...

How CMMI Value-Based Care Models Have Impacted Costs, Quality

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Many value-based care models have helped generate savings, reduce costs, and improve care quality, but models must incorporate health equity and clinical outcomes to achieve true value for all,...

Medicare ACO Healthcare Spending Recovered to Pre-Pandemic Levels

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Between 2019 and 2021, healthcare spending by accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) recovered to pre-pandemic levels but shifted from inpatient to...

Healthcare Orgs Push for Hybrid Primary Care Payment Option in MSSP

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More than 25 healthcare organizations have urged CMS officials to establish a hybrid primary care payment option in the Medicare Shared Savings Program (MSSP) to enhance primary care and boost...

NAACOS, AMA Push for Long-Term Value-Based Care Efforts

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Twelve healthcare organizations, including the National Association of ACOs (NAACOS) and the American Medical Association (AMA), have urged congressional leaders to engage with stakeholders and...

AMGA Calls on Congress to Advance Value-Based Care, Support Providers

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Congress should focus on advancing value-based care by investing in proper infrastructure, incentivizing patient engagement, and supporting continuous telehealth coverage, according to the American...

Value-Based Platform Will Join CMS Incentive Program to Support Rural ACOs

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Value-based care platform Signify Health announced plans to participate in the CMS Advance Investment Payments (AIP) incentive program to support providers in rural and underserved communities. Rural...