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Accountable Care Organizations (ACOs)

Heritage Medical Systems’ Voyage to Value—and How Physicians are Leading the Way

October 11, 2018  |  Rajiv Leventhal, Managing Editor
article
Mark Wagar, president of Heritage Physician Organizations, recently spoke with Healthcare Informatics about his organization’s value-based care journey, its ACO progress, and how physician culture can be changed.

At the HIT Summit in Raleigh, a Health Plan Executive Points to the Future of Value-Based Care

October 8, 2018  |  Mark Hagland, Editor-in-Chief
article
Speaking at the HIT Summit in Raleigh last month, Humana’s Ben Lunsford offered attendees insights into the future of value-based healthcare, and his health plan’s future intentions

Healthcare Executives Rank Data Analytics, Population Health as Top Challenges for 2019

October 3, 2018  |  Heather Landi, Associate Editor
news
Healthcare executive leaders identified leveraging data, particularly clinical data, to manage patients’ health, population health services and value-based payments as the top challenges they will face in the coming year, according to a survey by the Healthcare...

What to Expect Next from CMS Regarding the Proposed ACO Rule

October 1, 2018  |  Lynn Barr, Industry Voice, CEO and Founder, Caravan Health
article
In the accountable care community, we’re all anticipating the potential impacts of the recently proposed Medicare Shared Savings Program (MSSP) ACO (accountable care organization) rule.

Climbing Up the Risk Ladder: How National ACO Has Built a Winning Value-Based Care Infrastructure

September 27, 2018  |  Rajiv Leventhal, Managing Editor
article
National ACO—headquartered in Beverly Hills, Calif., but with providers in multiple states—has progressed through the federal ACO ranks in a way that could set the path for others

Premier Inc. Executives: Time to Unpack Some of the Challenges and Opportunities Inherent in the Path Into Risk

September 24, 2018  |  Mark Hagland
article
Shawn Griffin, M.D. and Steve Valentine of Premier Inc. discuss the challenges involved in the path into risk-based contracting, and the potential upending of the landscape by new disruptors

Is the Discourse Over the MSSP Program Teetering Towards Potential Conflict?

September 21, 2018  |  Mark Hagland, Editor-in-Chief
commentary
The joint statement by nine associations challenging CMS Administrator Seema Verma around her plans to insert more rigor into the MSSP program, feels like a teeter-totter moment for CMS

The CEO of a Nationwide Association of MD Groups Sees the Future—and It’s Not in Fee-For-Service

September 18, 2018  |  Mark Hagland
article
Don Crane, CEO of APG, a nationwide association of medical groups working in risk-based contracting, shares his perspectives on the future of medical groups in a shifting landscape

On Staten Island, a Highly Innovative Program That's Redefining What’s Possible Under Medicaid

September 17, 2018  |  Mark Hagland, Editor-in-Chief
article
Healthcare leaders on New York City's Staten Island have been achieving exciting success in population health management in their community’s Medicaid and uninsured populations

On Capitol Hill, Healthcare Leaders Raise Concerns with CMS’ Proposed ACO Rule

September 17, 2018  |  Heather Landi, Associate Editor
article
During a House subcommittee hearing, healthcare leaders voiced concerns that CMS' proposed changes to the MSSP ACO program will impede progress in the transition to value-based care.

Check and Checkmate: Is the Debate Around the MSSP ACO Program About to Get Super-Heated?

September 12, 2018  |  Mark Hagland
commentary
The publication this week in Health Affairs of a study sponsored by NAACOS that implicitly denounces CMS’s method for calculating the success of MSSP ACOs, is a fascinating move in a chess game playing out on multiple policy levels

Leading ACO Group: CMS is Calculating ACO Savings the Wrong Way

September 11, 2018  |  Rajiv Leventhal, Managing Editor
article
The Medicare Shared Savings Program generated gross savings of $1.84 billion for Medicare from 2013 to 2015, nearly double the $954 million estimated by CMS, according to a new analysis.

Putting Social Determinants of Health Data into Action

September 10, 2018  |  Heather Landi, Associate Editor
article
Leading hospitals, medical groups, and health systems, as well as ACOs and health insurers are moving forward to address social factors impacting health with a number of different approaches.

In Eastern North Carolina, an MD-Run ACO Shows its Success

September 10, 2018  |  Mark Hagland
article
Stephen Nuckolls, CEO of the New Bern, North Carolina-based Coastal Carolina Quality Care, shares his perspectives on why some physician-led ACOs are making huge breakthroughs on quality and cost

Congressional Leaders Voice Concerns about Stability of ACOs with Proposed MSSP Changes

September 7, 2018  |  Heather Landi, Associate Editor
news
In a letter to CMS Administrator Seema Verma, leaders of the U.S. House of Representatives Ways and Means Committee weighed in on several recently proposed regulations from CMS related to burden reduction, including the agency’s overhaul of Medicare’s Accountable...

Top Ten Tech Trends 2018: Markets and Medicine—Where Do Physicians Land, in the Emerging World of U.S. Healthcare?

September 5, 2018  |  Mark Hagland, Editor-in-Chief
article
Even as the purchasers and payers of healthcare push hard on physicians to embrace value-based care delivery and payment, doctors remain conflicted and ambivalent about the new healthcare.

Top Ten Tech Trends 2018: A Social Determinants of Health Technology Market is Slowly Emerging

September 4, 2018  |  Heather Landi, Associate Editor
article
The IT market for social determinants of health data is currently a nascent field with many providers using homegrown solutions, but adoption of SDoH technology is expected to grow quickly.

Is it Fair to Question CMS’ Agenda for Releasing ACO Results?

September 4, 2018  |  Rajiv Leventhal, Managing Editor
commentary
There is much debate on how one-sided risk ACOs are performing as new CMS data has been released

Top Ten Tech Trends 2018: Are the Lines Between Provider and Payer Organizations Beginning to Blur? To Some, That Would be Progress

September 4, 2018  |  Mark Hagland, Editor-in-Chief
article
As physician-based and hospital-based organizations plunge further into risk-based contracting, managing the contracts and the processes is turning out to be highly challenging for everyone.

The First 3 Things ACOs Should Do with Their Data

August 28, 2018  |  Aaron Elias, Industry Voice
article
New ACOs are inundated with many activities, from strategic decisions to technical requirements, but managing and using data should also rank highly on one's list of priorities.

Next Generation ACO Model Saves $62M in First Year, CMS Reports

August 28, 2018  |  Heather Landi, Associate Editor
news
The first cohort of ACOs in the Next Generation model generated net savings to Medicare of approximately $62 million while maintaining quality of care for beneficiaries for the 2016 performance year, according to a new evaluation report released by CMS.

Announcing Next Gen ACO Results, CMS Administrator Verma Makes the Case for Moving ACOs to Two-Sided Risk

August 27, 2018  |  Heather Landi, Associate Editor
article
During a webinar, CMS Administrator Seema Verma touted the results of the Next Gen ACO model as evidence that ACOs succeed under two-sided risk as CMS proposes major changes to MSSP ACO program.

PODCAST: Dr. Rita Numerof on CMS’ New ACO Proposals: “It’s Been a Long Time Coming”

August 23, 2018  |  Rajiv Leventhal, Managing Editor
article
A prominent healthcare consultant weighs in on a new regulation that could shake up the ACO landscape.

Assessing CMS’s Risky Move on Risk: Has Seema Verma Pushed MSSP ACOs Into Uncharted Territory?

August 13, 2018  |  Mark Hagland, Editor-in-Chief
commentary
Will Seema Verma’s August 9 announcement of CMS’s new “Pathways to Success” proposal light a fire under the MSSP ACOs, or will it cause provider organizations to flee? CMS officials are taking a risky gamble—with no clear outcome

BREAKING: CMS Proposes Sweeping Changes to MSSP ACO Program

August 9, 2018  |  Rajiv Leventhal and Heather Landi
article
The Centers for Medicare & Medicaid Services (CMS) is proposing a new direction for ACOs (accountable care organizations) in the Medicare Shared Savings Program (MSSP), with the goal to push these organizations into two-sided risk models.

At the Health IT Summit in Boston, One ACO’s Data-Facilitated Journey Into Value

August 7, 2018  |  Mark Hagland
article
What does it mean for an organization to pursue a data-facilitated journey into value-based care? Bill Gillis, CIO of the Beth Israel Deaconess Care Organization, shared his learnings and perspectives on that subject, at the Health IT Summit in Boston

Can Blue Cross of North Carolina Help to Reshape Its State’s Healthcare Landscape?

July 31, 2018  |  Mark Hagland
commentary
Remarks made by Patrick Conway, M.D. this spring point to some of the opportunities—and profound challenges—facing the shift towards a value-based healthcare system in North Carolina—and the challenges facing health insurers attempting to stimulate that change

At BIDCO, a “Pharmacy First” Approach to Population Health is Driving Promising Results

July 31, 2018  |  Heather Landi
article
Leaders at Beth Israel Deaconess Care Organization deployed a unique “pharmacy first” approach specifically to its Rising Risk Management program with the aim of achieving improved health outcomes in months, not years.

Glancing at the Boston Healthcare Provider Market: Consolidation and Physicians

July 28, 2018  |  Mark Hagland
article
Barbara Spivak, M.D., CEO of MACIPA, an area IPA, shares her perspectives on the prospects and context of a proposed mega-merger of Boston-area hospitals—and the impact of ongoing consolidation on physicians

Pondering the Psychology of Incentives in Bundled-Payment Contracts

July 27, 2018  |  Mark Hagland
commentary
Healthcare policy researchers, in an op-ed piece in the Health Affairs Blog, ponder the differences between prospectively and retrospectively based bundled payment incentives to providers—at a moment of early experimentation

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