The Center for Healthcare Quality & Payment Reform (CHQPR) offers steps to support its contention that value-based payment is only successful when explicitly designed to support value-based care, which the CMS Innovation Center says requires increased data sharing and the AMA warns is only possible when health systems/plans and...
In November, the Centers for Medicare and Medicaid Services (CMS) announced a Notice of Funding Opportunity (NOFO) for the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.
The AHEAD Model is intended to cut costs for states and improve overall patient health while advancing health equity, according to...
Most accountable care organizations (ACOs) participating in the final year of the Global and Professional Direct Contracting (GPDC) Model earned shared savings of while 23% reported losses in 2022. Collectively, the ACOs generated $870 million in gross savings after accounting for shared savings and losses and discounts paid, a 700%...
The Congressional Budget Office (CBO), which advises Congress on the budget and spending, published its most recent testimony on accountable care organizations (ACOs) and the Center for Medicare and Medicaid Innovation (CMMI).
As noted last week, the CBO found that CMMI was directly responsible for an increase in spending of $5.4...
The Centers for Medicare and Medicaid Services (CMS) announced the creation of a new payment model for people diagnosed with dementia.
The Guiding an Improved Dementia Experience (GUIDE) Model is an alternative payment model focused on preserving quality of life for diagnosed dementia patients while keeping them at home and providing...
Adding a seventh track to the advanced payment model would provide a better bridge from the Medicare Shared Savings Program (MSSP) to the ACO REACH model, according to the National Association of Accountable Care Organizations NAACOS. CMS is taking your comments.
According to a NAACOS blog post by David Pittman, the organization's...National News
The Center for Medicare and Medicaid Innovation (CMMI) was accused of harming access to innovative drugs during a House Ways and Means Health Subcommittee meeting last week. GOP lawmakers are taking issue on a proposed CMMI model designed to test strategies to make it easier for Medicare patients to afford and access needed prescriptions...Arizona News
This week, accountable care has a new definition following the Health Care Payment Learning and Action Network (LAN) Summit, and the Centers for Medicare and Medicaid Services (CMS) look to get more Affordable Care Act (ACA) plans into value-based insurance design.
Out with the old, in with the new. LAN received feedback from...National News
Last year, the Centers for Medicare and Medicaid Services (CMS) announced a roadmap for its strategic vision and priorities to expand equitable access to health coverage and promote value-based, person-centered care. The Center for Medicare and Medicaid Innovation (CMMI) illustrated its vision through five main objectives to guide its...White Papers, E books, Reports and more
The National Academy of Medicine (NAM), an independent organization that serves as a national adviser on health and medicine with the National Academy of Sciences and the National Academy of Engineering, released a Special Publication on the lessons learned and path forward for the Center for Medicare and Medicaid Innovation (CMMI) and...Arizona News
The Center for Medicare and Medicaid Innovation (Innovation Center) announced the provisional acceptance of 110 Accountable Care Organizations (ACOs) applications to the ACO REACH model. We have identified seven ACOs that made the provisional list to operate in Arizona. Four REACH ACOs are already operating in the state as part of the...National News
After a long wait, the Centers for Medicare and Medicaid Innovation (CMMI) announced that it has provisionally accepted 128 participants for the Participation Year 2023 cohort of the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model. The ACO REACH model is the redesign of the Global and...CMS Rules
Earlier this year, President Joe Biden relaunched his Cancer Moonshot Initiative, which was initially established under the Obama administration to accelerate research into cancer prevention and cures. As part of the initiative, the Biden administration announced a new alternative payment model (APM) from the Center for Medicare and...National News
Value-based care is now a ubiquitous term across the medical industry, primarily led by Medicare payment models that prioritize quality of care above overall cost. But some are questioning the concept's utility and expanse over the Medicare market.
Legislation proposed in both the U.S. House of Representatives and Senate would...
More than a dozen pages cover what you need to know about Advanced Payment Models (APMs) including Accountable Care Organizations (ACOs), Direct Contracting Entities (DCEs) and Value-based Networks (VBNs) competing for Primary Care Physicians (PCPs) and beneficiaries in Arizona. Taking risk for the quality and cost of care is making...
This week in value-based care (VBC), the Biden Administration is making headway on its goal to reform alternative payment models (APMs) for the Medicare program to boost program savings and advance the administration's goal of health equity in medicine.
MIPS
To get a refresh on value-based care models including the Quality Payment...Arizona News
Equality Health, a popular value-based contracting partner in Arizona, is now seeking primary care providers and specialists to join its new direct contracting entity: Equality Health Direct, which began operations in January 2022.
Direct contracting entities (DCEs) participate in the Global and Professional Direct Contracting...
The success of Medicare Advantage (MA) can't be understated. In the last 11 years, the program has grown to represent nearly 50% of the Medicare-eligible market, a benchmark it will likely pass within the next year.
Arizona MA growth reflects the program's national success. At the Hertel Report's 2020 Winter State of the State, Dan...
In late February, the Centers for Medicare and Medicaid Services (CMS) announced that after a full year of review, it would overhaul the Global Professional Direct Contracting Model and create the Accountable Care Organization (ACO) Realizing Equity, Access and Community Health (REACH) model. The redesign was intended to address...National News
The Biden administration has pledged to provide Americans with better in-roads to health coverage and to even the playing field for people at a systemic disadvantage from receiving adequate healthcare. This week, a number of policy decisions highlight the administration's commitment to these goals in Medicare coverage, health equity and...
