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Accountable Care Organizations (ACOs)

Reinventing Utilization Management to Bring Value to the Point of Care

February 21, 2018  |  Nilo Mehrabian Vice President, Product Management, Decision Support, Change Healthcare
article
How an automated exception-based approach can make UM more efficient and effective.

When It Comes to The Big Debate on ACOs, What Is “Big Enough” Savings?

December 12, 2018  |  Mark Hagland, Editor-in-Chief
commentary
The back-and-forth interaction between CMS Administrator Seema Verma and the ACO community is unfolding in a fascinating, if unpredictable way, at a key inflection point in the evolution of the MSSP program

EXCLUSIVE: NAACOS President Foresees “Shrinkage in Accountable Care Movement” Pending MSSP Final Rule

December 5, 2018  |  Rajiv Leventhal, Managing Editor
article
Clif Gaus, NAACOS president and CEO, speaks out on a few key problems that his organization, and others, have with CMS’ proposed changes to the MSSP.

At the D.C. Department of Health Care Finance, Digging into Data Issues to Collaborate Across Healthcare

November 22, 2018  |  Mark Hagland, Editor-in-Chief
article
Kerda DeHaan and her colleagues at the D.C. Department of Health Care Finance are tackling granular data management issues to expand their collaboration with health plans and providers

The 2019 Healthcare Informatics Innovator Awards Program is Open

November 15, 2018  |  the Editors of Healthcare Informatics
article
The 2019 Healthcare Informatics Innovator Awards Program is now open for submissions. As always, it’s a great privilege and pleasure for us to sponsor this program.

Olympic Marathons: Performance Improvement Initiatives Help to Power the Long Race

November 14, 2018  |  Mark Hagland, Editor-in-Chief
article
At a time when providers are being pushed to rework patient care delivery to deliver value, formal performance improvement initiatives are helping to achieve clinical and operational transformation.

At the Beverly Hills HIT Summit, APG’s Crane Offers a Vision of the Future of Medical Care

November 11, 2018  |  Mark Hagland, Editor-in-Chief
article
Don Crane, CEO of APG, a nationwide association of physician groups involved in risk-based contracting, offered HIT Summit attendees a vision of a coordinated care-based future

The Key to Clinical and Financial Success? Atrius Health President Gives Out His Recipe

November 8, 2018  |  Rajiv Leventhal, Managing Editor
article
Atrius Health’s president and CEO, Steven Strongwater, M.D., discusses the organization’s population health initiatives that have led to strong clinical and financial performances.

In Northern Virginia, Rethinking ACO Strategies—For PCPs and Specialists

October 30, 2018  |  Mark Hagland, Editor-in-Chief
article
Tricia Nguyen, M.D., a senior executive at the Falls Church, Va.-based Inova Health System shares her perspectives on what she and her colleagues are learning about some of the underlying challenges in ACO work

Lawmakers Urge CMS to Modify Final Medicare ACO Regulation

October 24, 2018  |  Heather Landi, Associate Editor
news
bipartisan group of nine lawmakers today sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma asking for two key changes to the agency’s recently proposed rule that would reform the Medicare Shared Savings Program (MSSP...

Healthcare Groups to CMS: ACOs Need More Time in One-Sided Risk Models

October 17, 2018  |  Rajiv Leventhal, Managing Editor
article
Healthcare associations have written to CMS, urging the agency to reconsider its proposed regulation that would push ACOs more quickly into two-sided risk models.

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

On the Road to Risk, Summit Medical Group is Driving in the Fast Lane

October 2, 2018  |  Rajiv Leventhal, Managing Editor
article
In a recent interview with Healthcare Informatics, Jeffrey Le Benger, M.D., outlined the progress and evolution of his organization and how it’s continuing to plunge ahead into the world of risk and value-based care.

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

NAACOS, AMA, Others Urge CMS to Reconsider MSSP Proposed Changes

September 21, 2018  |  Rajiv Leventhal, Managing Editor
news
NAACOS and eight other healthcare stakeholder groups have sent a letter to CMS, expressing concerns about the federal agency’s proposed changes to the Medicare Shared Savings Program.

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...

In the Emerging World of Risk-Based Contracting, Data Analytics Is a Foundational Necessity

September 7, 2018  |  Mark Hagland, Editor-in-Chief
article
With the emergence of more risk-based contracting, including two-sided risk, data analytics has now become fundamental to patient care organizations’ operational and financial success.

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.

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