Last week, LeadingAge published a white paper that describes the difficulties Medicare Advantage members face accessing payment for post-acute care services.
The white paper, "Fulfilling the Promise: Medicare Advantage," identifies the issues that many beneficiaries face when attempting to access benefits, such as delays, unnecessary...
As the national mental health crisis worsens, in part due the COVID-19 pandemic for patients and healthcare workers alike, behavioral healthcare integration is at the top of industry priorities. This week, health care payers of all stripes are innovating solutions to covering costs.
The Medicare Payment Advisory Commission (MedPAC)...Arizona News
The VillageMD partnership with Walgreens is on the rise with a finalized deal to acquire Summit Health. There are currently 30 Village Medical at Walgreens locations in the Phoenix and Tucson areas.
Last week, VillageMD announced in a quarterly earnings call that the $8.9 billion acquisition of Summit Health closed on January 3....Arizona News
The partnership kicks off in the New Year, Jan. 1, 2023, and is expected to bring improved patient and provider services to PathfinderHealth primary care practices in northern Arizona, and help PathfinderHealth, a clinically integrated network and accountable care organization (ACO), navigate the transformation to value-based healthcare...
Last week, the Health Care Payment Learning and Action Network (LAN) published its 2022 Methodology and Results report, which is the result of a data collection survey of health plans and states for an account of how money moves through alternative payment models and how these programs function in terms of barriers and access.
In...
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...Arizona News
Integral Health Network of Southern Arizona is independently operated by CODAC Health, Recovery & Wellness, Community Bridges, Helping Ourselves Pursue Enrichment, Horizon Health and Wellness, and La Frontera Arizona.
Billed as an accountable care organization, the network launched last month and uses value-based care principles...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...
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...
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...
Last Wednesday, the Medicare Payment Advisory Commission (MedPAC) published its biennial report to Congress which included recommendations to streamline alternative payment models (APMs) within the Medicare program. It also recommended a strategy to improve accuracy in Medicare Advantage (MA) payments and correct a major contributor to...
This week in value-based care, a fresh look at untangling VBC for providers looking to enter into an ACO or payment model, results from the Comprehensive ESRD Care Model, and some market moves in long-term and home healthcare.
A new study published in Health Affairs on Monday demonstrates that the first Medicare accountable care...National News
The California pilot: an alternative payment model (APM) for Federally Qualified Health Centers (FQHCs) to swap out the traditional volume-based prospective payment system with one that emphasizes principles of value-based care. In other news, CareMax will serve as the value-based management services organization to Steward's entire...National News
Value-based care is undoubtedly helped by new technologies and information-sharing for providers and insurers alike, but the problems that VBC faces are multifaceted and require more than just an assist from software.
Health information exchanges (HIEs) are in a uniquely strong position to help payers and providers in the quest for...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...National News
This week, value-based care (VBC) is frequently seen as a method for primary care providers to best serve patients, but increasingly more facets of the healthcare industry are investigating how technology, data analytics and value-based insurance design can help swap volume for value and deliver results for their patients.
Hospitals...News
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...National News
This week in value-based care, CMMI director Elizabeth Fowler defends criticism of the ACO REACH payment model, CMS improves ACO quality care reporting and data aggregation, the White House moves to support a value-based program for skilled nursing facilities, FQHCs struggle to keep up with systemic transformation and MedPAC moves to...
