The Centers for Medicare & Medicaid Services (CMS) is launching a new initiative Investing in Health Outcomes with 37 states to shift Medicaid quality measurement away from process and paperwork and toward measurable improvements in patients' health.
Inside Health Policy reported that participating states are expected to focus on:...National News
The Centers for Medicare & Medicaid Services (CMS) is expanding its ACCESS Model beyond Original Medicare, bringing its technology-enabled approach to Medicaid, Medicare Advantage and private insurance while adding payments for physicians who participate in patients’ digitally supported care.
Major insurers, including...Available To All
Medicare’s ACCESS chronic-care model will add four new condition tracks next spring, doubling down on its effort to tie payments to patient outcomes rather than volume of care.
The Advancing Chronic Care with Effective, Scalable Solutions, or ACCESS, voluntary model is designed to give Medicare beneficiaries more options for managing...
The Center for Medicare and Medicaid Innovation (CMMI) was created by the Affordable Care Act of 2010 to creatively work through issues of healthcare quality and rising health costs through demonstrations of payment mechanisms that prioritize health outcomes, commonly referred to as "value-based care." The expectation has been that at...White Papers, E books, Reports and more
One in five American children has a chronic health condition, with even higher rates among those enrolled in Medicaid and the Children’s Health Insurance Program. The trend raises questions about how to address underlying systemic drivers and whether value-based care models can help improve outcomes for children and youth.
The...
The healthcare sector is aggressively incorporating AI into all levels of productivity as products become available to meet the market's niche needs. This week, the Healthcare Information and Management Systems Society (HIMSS) Global Health Conference and Exposition in Las Vegas showcases the breadth of AI capabilities.
Systems that...
The issue brief from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) argues that technology-enabled care, including AI, telehealth, and remote patient monitoring, will only deliver value if payment models shift away from FFS and toward outcomes-aligned, value-based care.
ASPE warns that under fee-for-service...
The American Medical Association (AMA) is praising a new Innovation Center voluntary initiative aimed at bringing technology-supported chronic care squarely into Original Medicare, calling it a long-needed move to remove payment barriers that prevent physicians from using digital tools shown to improve outcomes.
This week the Centers...Arizona News
On Wednesday, P3 Health Partners and Commonwealth Primary ACO announced the formation of a Joint Venture Management Services Organization for its ACO lines of business.
P3 Health Partners is a leading population health management company founded and led by physicians with more than 2,800 affiliated primary care providers nationwide...National News
Oak Street Health, the Medicare-focused primary care chain owned by CVS Health continues to grapple with rising medical costs. Optum Health is similarly fighting market challenges to establish UnitedHealth's care delivery arm in a volatile provider market.
This week, Oak Street announced that it would cut 219 jobs in restructuring...News
A new policy brief from the influential Washington-based Paragon Health Institute warns that Congress should either reform or shut down the CMS Innovation Center, arguing the program has failed to deliver meaningful savings or quality improvements despite costing taxpayers billions. The report concludes that, after more than a decade of...White Papers, E books, Reports and more
In August, Milliman released a new four-part series exploring what providers need to know about entering VBC arrangements. This first white paper outlines the types of value-based contracts, the risks providers should evaluate, and the organizational factors that determine readiness for success.
Rising healthcare costs for patients,...
According to Milliman actuaries, the significant financial updates to the ACO REACH model for Performance Year 2026 announced in May signal CMMI’s growing concern over increased spending within the model and a pivot toward its broader strategic goals. The firm analyzes each policy change and estimates its financial impact.
Laid out...
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...
Integrated Medical Services (IMS), one of Arizona's largest, independent multi-specialty practices, will now serve as the anchor practice for Privia Medical Group - Arizona; IMS will continue to be physician-owned and operated.
Privia Health is one of the largest physician enablement companies in the United States, operating in 15...Top of The Day
The large employer advocacy group Business Group on Health has published seven calls to action for the healthcare industry and employers to take up in order to accelerate the adoption of value-based care models, which is expected to improve patient care and lower costs across the board.
The group notes that adoption of the payment...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 Medicare Shared Savings Program (MSSP) is one of the country's largest value-based payment programs, serving nearly 11 million Medicare beneficiaries. In 2023, the program saved Medicare $2.1B, the largest savings in the program's history. In Arizona, 17 MSSP Accountable Care Organizations (ACOs), some which serve several states...
This week, trade associations ask regulators to reform requirements for participation in value-based care initiatives and improving alternative payment models to drive adoption of value-based care.
The American Medical Association, the Association of Medical Colleges, the Medical Group Management Association, and the National...National News
The transition to value-based care (VBC) continues and the American Medical Association (AMA) and the CPT Editorial Panel published an issue brief this week on the acceleration of its adoption through the CPT code set.
As more providers transition to accountable care organizations (ACOs) and other team-based care relationships, the...
