The Wakely Consulting Group analysis found physician-led and lower-revenue ACOs were especially effective at generating savings as patient risk increased, outperforming larger, hospital-based ACOs managing higher risk populations.
The paper's authors also found that higher quality scores consistently correlated with stronger financial...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) proposed the first pay boost for physicians in five years in its proposed 2026 Physician Fee Schedule (PFS). The proposed rule also contains means to curb spending and introduces billing codes for behavioral health and chronic disease.
Physicians groups have warned for the past five...
In April, NAACOS signaled its intent to work with new CMS Administrator Mehmet Oz on the future of value-based care, as new JAMA studies this week highlighted savings from MSSP and shortcomings in the REACH ACO model. Oz also faced pressure from Congressional Republicans this week, who accused CMMI of advancing costly models that miss...
The Centers for Medicare and Medicaid Services (CMS) announced last week that it would cut four Medicare payment models, including Maryland Total Cost of Care, Primary Care First, ESRD Treatment Choices and Making Care Primary.
The models will end at the close of 2025, a year earlier than anticipated for all programs. According to...National News
The transition to value-based care has been ongoing for years. Although advances have certainly been made over the past decade, many have noticed that the switch is taking quite a while. This week, several experts and organizations weigh in on why the transition is slow, and what could speed it up.
Consistently, the leading issues...
The rule is designed to advance health equity and support whole-person care. Medicare physician payments would decline 2.9% in 2025 under the new proposed policy from CMS that also aims to offer six new MIPS Value Pathways (MVPs): ophthalmology, dermatology, gastroenterology, pulmonology, urology, and surgical care.
The Centers for...
After discovering widespread fraud amounting to billions of inaccurate billing for catheters, the Centers for Medicare and Medicaid Services (CMS) proposed a rule absolving participating accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP).
In 2023, CMS observed "significant, anomalous, and highly...Top of The Day
Accountable care organizations (ACOs) and their practices have taken on the full focus of Medicare's value-based care initiatives through the Medicare Shared Savings Program (MSSP) and the ACO Realizing Equity, Access and Community Health (ACO REACH) programs.
A new study published in the JAMA Health Forum looks at survey results from...National News
Despite high hopes for the Medicare Shared Savings Program (MSSP) and agency reports that the model produced about $250 million in savings annually, these findings suggest the savings produced by the federal government's largest alternative payment model (APM) had only a minor financial impact on the Centers for Medicare & Medicaid...National Reports & Surveys
New studies are showing the benefits of value-based care organizations, including the rapid rise of accountable care organizations (ACOs).
Physician participation in accountable care organizations (ACOs) has increased to represent most doctors, according to a survey of 3,500 physicians by the American Medical Association (AMA)....
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) finalized the 2024 Medicare Physician Fee Schedule rule, which includes a 3.34% decrease to the schedule's conversion factor, setting it at $32.74, a $1.15 decrease from 2023.
The agency finalized other increases for visits including primary and longitudinal care, and...
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...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) CY 2024 Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) proposed rules released this week have caught major criticism from the industry for cuts to physician pay and inadequate raises for hospitals. But the OPPS proposal also contains a number of...
On Tuesday, the Centers for Medicare and Medicaid Services (CMS) announced the participants for the Medicare Shared Savings Program (MSSP), the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) Model, and the Kidney Care Choices (KCC) Model.
CMS boasted more than 700,000 providers and...
A snapshot of Arizona hospital-based health systems in Arizona including their size and scope, net profits, net margins, patient revenue, payor mix, quality ratings, partnerships, ACO affiliations, leadership lists, and more. Also included: the latest news on Rural Emergency Hospitals and the complicated financials of nonprofit...
The Centers for Medicare and Medicaid Services (CMS) has released the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) final rule that reduces payments by almost 4.5% YOY and includes substantive changes for ACOs in the Medicare Shared Savings Program, expands access to behavioral health services, and decreases the conversion factor...National News
President Biden has set a goal of ending hunger and increasing healthy eating and physical activity by 2030 so fewer Americans experience diet-related diseases, which disproportionately impact communities of color, rural communities, people with disabilities, veterans, older adults, LGBTQI+ populations, and military families.
The...Arizona News
The majority of Accountable Care Organizations participating in the Medicare Shared Savings Program in Arizona brought home shared savings in 2021. The biggest local earner: Banner Health Network ($26M). Other local ACOs that earned shared savings from the Centers for Medicare & Medicaid Services include North Central Arizona...National News
At this time two years ago, the future of alternative payment models (APMs) and accountable care organizations (ACOs) was uncertain and to some degree the entire landscape of value-based care hung in the balance while the Trump administration sorted out the details of the Direct Contracting payment models. But now, under the Biden...
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) published the proposed 2023 physician fee schedule (PFS) which included an overhaul to the agency's strategies on accountable care organizations (ACOs) through the Medicare Shared Savings Program (MSSP).
In February, CMS pulled the Accountable Care Organizations...
