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Accountable Care Organizations (ACOs)

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

August 13, 2018  |  Mark Hagland
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

Could Last Week’s Proposed-Rule Release Represent an Inflection Point for CMS and for Value-Based Federal Payment?

July 18, 2018  |  Mark Hagland
commentary
CMS’s release of a proposed rule that will impact a range of issues, from physician payment to quality measures, has unleashed a range of reactions from industry leaders—could this prove to be an inflection point?

Aligning Incentives in the Forward Evolution Around Value-Based Payment: Major Obstacles Cited

July 16, 2018  |  Mark Hagland
commentary
The implications of a recent HFMA-sponsored analysis of value-based healthcare are many—and challenging, for the pioneers of VBP in new payment models in U.S. healthcare

The Rocky Path to Value for Medicaid Programs—and HIT’s Key Role in Making It All Work

July 11, 2018  |  Mark Hagland
commentary
Medical researchers share some insights on the broad range of challenges facing the pioneers attempting to move Medicaid towards value-based payment incentives, including around the key role that HIT and data analytics will play in success

Cerner, Lumeris Partner on Value-Based Care Solution

July 9, 2018  |  David Raths
news
Health IT vendors Cerner and Lumeris have announced a long-term partnership and a new product offering, Maestro Advantage, for value-based arrangements, including Medicare Advantage and provider-sponsored health plans.

Can We Get to the Next Level When It Comes to Quality Measures for the Care of Patients with Complex Needs?

June 27, 2018  |  Mark Hagland
commentary
A commentary posted online on Tuesday on the Health Affairs website makes important points about the landscape around the measurement of quality in the context of care for patients with complex needs

Analysis: Early Years of VBP Models Show Limited Impact on Reducing Cost of Care

June 25, 2018  |  Heather Landi
news
The penetration of population-based value-based payment models is not yet having an impact on curbing growth in total cost of care, according to a new analysis by the Healthcare Financial Management Association (HFMA), Leavitt Partners and McManis Consulting.

Geisinger CEO Will Not Join Amazon/Berkshire/JP Morgan Chase Healthcare Initiative

June 12, 2018  |  Mark Hagland
news
Despite initial discussions about his possibly joining the new Amazon/Berkshire Hathaway/JP Morgan Chase healthcare venture, David Feinberg, M.D. stated definitively on Jan. 30 that he will remain CEO of Geisinger Health System

The Strategic and Strategic-IT Challenges Around Risk: Premier Execs Share Their Thoughts

June 11, 2018  |  Mark Hagland
article
Joe Damore, Shawn Griffin, M.D., and Mark Hiller, senior executives at Premier Inc., share their perspectives on the strategic-organizational and strategic-IT challenges involved, as patient care organizations begin to move into risk-based contracting

Value-Based Care’s Landscape Tilt

May 31, 2018  |  Mark Hagland
article
As the healthcare landscape shifts, U.S. healthcare leaders are learning valuable lessons in how to prepare broadly to take on financial risk in contracts with the public and private purchasers and payers of healthcare, and how to engage and align physicians.

Is It Time to Totally Rethink the Concept of Patient Engagement?

May 30, 2018  |  Mark Hagland
commentary
It was fascinating to listen to Dr. Katherine Schneider’s keynote presentation in Philadelphia, “Patient Engagement Is Not an App”—and to ponder the implicit challenge she posed to her audience

A Cloudy HIT Policy Picture is Beginning to Clear Up

May 29, 2018  |  Rajiv Leventhal
article
At this time last year, healthcare stakeholders were filled with uncertainty, as the future of healthcare policy remained very much in limbo. But in the past several months, an air of stability has presented itself.

At the Philadelphia HIT Summit, One Healthcare Leader Parses the Current State of Payer-Provider Convergence

May 24, 2018  |  Heather Landi
article
As the healthcare industry makes steady progress to value-based care models, one healthcare thought leader sees the commercial payer market playing a larger role, going forward, in pushing provider organizations into value-based care arrangements.

Advantage: Interoperability

May 22, 2018  |  Joe Marion
commentary
Recent discussions emphasize the advantages of interoperability within and between healthcare providers.

Dr. Glenn Steele on the Path Forward Towards Care Delivery Transformation

May 20, 2018  |  Mark Hagland
article
Healthcare Informatics caught up recently with Glenn D. Steele, Jr., M.D., Ph.D., who has been busy spreading the gospel of the Geisinger approach to healthcare delivery innovation, U.S. healthcare system-wide

In Michigan, Prime ACO is in the Risk Game, with Eyes on the Big Picture

May 17, 2018  |  Rajiv Leventhal
article
Still in a one-sided risk model, the Michigan-based ACO is working its way toward taking on downside risk

Are Federal Health Officials Fed Up With Providers’ Unwillingness to Take on Downside Risk?

May 14, 2018  |  Mark Hagland
commentary
A series of tough public statements by senior federal healthcare officials point to an underlying problem: the federal experiment with accountable care isn’t moving the needle fast enough to really bend the overall healthcare cost curve

At HLTH, a Candid Discussion of What the Federal Government Can and Should Do to Promote Healthcare Innovation

May 11, 2018  |  Mark Hagland
article
At the HLTH Conference this week, Rasu Shrestha, M.D. of UPMC sat down with HHS CTO Bruce Greenstein and former United States CTO Aneesh Chopra, to discuss the federal government’s role in facilitating technology innovation

Advocacy Group Formed to Promote Independent Physicians’ Roles in Value-Based Care

May 10, 2018  |  David Raths
news
Several physician-focused healthcare organizations have united to form the Partnership to Empower Physician-Led Care (PEPC) to advocate for the role of independent physician practices in value-based care.

EXCLUSIVE: Substantial ACO Reforms Could be Forthcoming

May 9, 2018  |  Rajiv Leventhal
article
Healthcare Informatics has learned that a CMS rule is forthcoming that could shorten the duration ACOs can stay in one-sided risk models.

At the HLTH Conference, Former CMMI Director Patrick Conway Looks Back, and Forward

May 8, 2018  |  Mark Hagland
article
Patrick Conway, M.D., CEO of Blue Cross and Blue Shield of North Carolina, was interviewed as part of a general session at the HLTH Conference—looking back on his tenure as CMMI Director, and forward into the future

At HLTH, David Feinberg, M.D. Shares Why Geisinger Is Investing in the Full Health of Its Communities

May 7, 2018  |  Mark Hagland
article
On the first day of the HLTH conference in Las Vegas, David Feinberg, M.D., CEO of Geisinger, articulated a bold, broad vision of his organization’s embrace of the widest possible view of its role in its communities

For One North Carolina ACO, a Social Determinants-Driven Strategy is Reaping Results

May 4, 2018  |  Heather Landi
article
At Mission Health Partners, an Asheville, North Carolina-based Medicare ACO, a unique care coordination approach, focused on addressing the social and environmental issues underlying patients' health problems, has proven successful.

HHS Secretary Alex Azar Gives Industry Leaders a Map of the New Healthcare

May 4, 2018  |  Mark Hagland
commentary
On Wednesday at the World Health Care Congress in Washington, D.C., HHS Secretary Alex Azar offered attendees a conceptual map of the new healthcare, at least from the standpoint of federal healthcare policy

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