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Accountable Care Organizations (ACOs)

Survey: By 2019, 60% of Medicare Revenues will be Tied to Risk

December 13, 2017  |  Rajiv Leventhal
news
Medical groups and health systems that are members of AMGA (the American Medical Group Association) expect that nearly 60 percent of their revenues from Medicare will be from risk-based products by 2019, according to the results from a recent survey.

Market Profile: San Diego’s Leaders Manage Parallel Trajectories When It Comes to Population Health

December 12, 2017  |  Mark Hagland
article
San Diego is one of the more advanced metro healthcare markets, with a long history of risk-based contracting; yet providers must manage both risk-based and FFS contracting, in parallel environments, to be successful

Lawmakers Introduce Legislation Aimed at Improving Medicare ACO Program

December 8, 2017  |  Heather Landi
news
U.S. Representatives Peter Welch (D-VT) and Rep. Diane Black (R-TN) have introduced H.R. 4580, the ACO Improvement Act of 2017 that makes changes to the Medicare accountable care organization (ACO) program.

Catalyst for Payment Reform’s Suzanne Delbanco on ACO Measurement and the CVS-Aetna Deal

December 8, 2017  |  Mark Hagland
article
Suzanne Delbanco, Ph.D. of Catalyst for Payment Reform, which is focused on helping employer-purchasers get value for their spending, shares her perspectives on the CVS-Aetna merger, and on CPR’s new ACO value measurement tool

Ten Steps to Reduce Denials, Win More Appeals, and Improve Hospital Performance

December 8, 2017  |  Carol Everhart, RN, MS, IQCI, Senior Clinical Consultant, Decision Support Change Healthcare
article
Hospitals everywhere are striving to answer this question: How can we better manage denials? Denials related to medical necessity account for about 5% of denials nationally. But by closing common gaps that lead to medical necessity denials, your...

Southwestern Health Resources ACO Saves Medicare $37M in 2016

November 28, 2017  |  Healthcare Informatics
news
The Southwestern Health Resources Accountable Care Network has saved the government more than $73 million over the last three years, including about $37.3 million in 2016.

Healthcare Industry Leaders Submit Comments on Future of CMMI

November 21, 2017  |  Heather Landi
news
Responses to the CMS' request for information on the Innovation Center New Direction were due Monday, and several health IT and healthcare industry organizations submitted feedback on the future of CMMI.

Research Finds States Remain Committed to Value-Based Payment Models

November 16, 2017  |  Carolyn Wukitch, Senior Vice President & General Manager, Network & Financial Management, Change Healthcare
article
Alternative payment programs are now firmly rooted in state-level healthcare policy, as discussions regarding health reform continue in Washington. That’s according to a new national study commissioned by Change Healthcare which finds over 40 states pursuing...

Premier Submits Comments on Future of CMMI

November 15, 2017  |  Rajiv Leventhal
news
In its comments to CMS, Premier officials highlighted how critical it is for CMMI to continue to serve as a leader in testing value-based care models, incorporating the successes of past models into new models.

Lessons Learned from the Trenches of Healthcare Policy

November 15, 2017  |  Rajiv Leventhal
article
A former OMB director discusses federal rulemaking, the future of CMS’ Innovation Center, and if the push toward value-based care has been slowed at all in recent months.

Over 40 U.S. States Pursuing Value-Based Payment Programs, Report Finds

November 14, 2017  |  Rajiv Leventhal
news
Alternative payment programs are becoming entrenched in state-level healthcare policy, according to a new study from Change Healthcare, which found that at least 40 states are pursuing value-based payment programs, with 15 multi-payer initiatives across those...

A Rural Healthcare CIO Speaks Out on East Texas’ Barriers to Value-Based Care

November 10, 2017  |  Rajiv Leventhal
article
ETMC Regional Healthcare System’s CIO spoke to Healthcare Informatics about the organization’s biggest challenges right now as it relates to healthcare IT and value-based care, as well as other trends and innovation going on in the region.

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