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Accountable Care Organizations (ACOs)

ACO Company Caravan Health Touts Continued Growth

January 11, 2018  |  Rajiv Leventhal
news
Kansas City-based Caravan Health, a builder of accountable care organizations (ACOs), today announced the addition of 103 new health systems and 15 ACOs to its group of partners.

Medicare Shared Savings Program Gets 124 New ACOs for 2018

January 9, 2018  |  Rajiv Leventhal
news
The Centers for Medicare & Medicaid Services (CMS) has said that there will be 124 new accountable care organizations (ACOs) that will participate in the Medicare Shared Savings Program (MSSP) in 2018.

Premier Voices Support for Alex Azar’s HHS Nomination

January 8, 2018  |  Rajiv Leventhal
news
The Charlotte, N.C.-based Premier, Inc., has written to two senators on the Senate Health, Education, Labor and Pensions (HELP) Committee showing support for Alex Azar to become Secretary of the Department of Health and Human Services (HHS).

Massachusetts ACO Certification Program Now Includes 17 Members

January 5, 2018  |  Rajiv Leventhal
news
Netwon, Mass.-based Atrius Health has been certified as an accountable care organization (ACO) by the Massachusetts Health Policy Commission (HPC) in what officials call is a first-in-the-nation certification program.

What’s the Driving Force Behind UnityPoint Health’s Continued ACO Success?

January 3, 2018  |  Rajiv Leventhal
article
Leaders point to past experiences in value-based care programs, being data-driven, and having a strong focus and consistent messaging as reasons for strong ACO results

Looking at San Diego’s Healthcare Landscape: What Can Advanced Markets Teach Us?

January 3, 2018  |  Mark Hagland
commentary
What can we learn from the leaders of the San Diego healthcare market? As it turns out, a lot—about collaboration, payer-provider relations, taking on risk-bearing contracts, population health—and more. And what the provider and payer leaders are learning in that...

Edging into 2018, Could 2017 Turn Out To Have Been an Inflection-Point Year?

January 1, 2018  |  Mark Hagland
commentary
It feels as though 2017 was an important year in the preparation on the part of advanced patient care organizations, to plunge more deeply into risk-based contracting—at a time of accelerating risks to providers (including cybersecurity risks) of all kinds

In New York State, a Unique MSSP ACO Cares for Patients with Intellectual Disabilities

December 20, 2017  |  Mark Hagland
article
In New York state, the Alliance for Integrated Care of New York (AICNY) is leveraging data and analytics in order to optimize care delivery to patients with intellectual and developmental disabilities

A Framework for the Future: 3 Steps to Building an Enterprise Architecture

December 18, 2017  |  Bob Hoover, VP of Consulting Services at Change Healthcare
article
Successfully delivering value from healthcare IT investments is difficult. That’s a refrain I’ve heard again and again from healthcare leaders, whether in the boardroom, the executive suite, or the data center.

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.

Good Signs: NYC Health + Hospitals Corporation Boasts a True ACO Success Story

November 9, 2017  |  Mark Hagland
commentary
New York City Health & Hospitals Corporation’s leaders have been able to boast very impressive results from their organization’s MSSP work--results that offer hope for leaders from all types of patient care organizations

Unnecessary Care: It’s Not Necessary

November 2, 2017  |  Suresh Yarlagadda, Medical Director, Clinical Strategy, Change Healthcare
article
Unnecessary care is unnecessarily in the news these days. We say “unnecessarily” because such care—as well as the associated costs it incurs and risks it poses for patients—can be mitigated. Kaiser Health News just published a report, “So Much Care It Hurts...

Report: 29 Percent of Healthcare Payments in 2016 Tied to APMs

November 1, 2017  |  Heather Landi
news
Nearly one-third (29 percent) of total U.S. health care payments were tied to alternative payment models (APMs) in 2016, a six percentage point increase from 2015, according to a report from the Health Care Payment Learning and Action Network (LAN).

A CIO Explores Dallas-Fort Worth’s Biggest HIT Challenges, Opportunities

October 18, 2017  |  Rajiv Leventhal
article
Pamela McNutt, a veteran CIO with 30 years of experience in health IT, discusses how CIOs can help reduce physician burnout, and what innovation she’s seeing these days in the Dallas region.

New CMS Data on ACOs: Maybe Not a High-Speed Train, But a Train Nonetheless

October 17, 2017  |  Mark Hagland
commentary
CMS’s release last week of data from the Pioneer and Next Gen ACO programs revealed genuine progress being made among participating ACOs—with lots of opportunity for ongoing improvements, of course

CMS Releases 2016 Next Generation ACO Data with Positive Financial, Quality Results

October 16, 2017  |  Rajiv Leventhal
article
The Centers for Medicare & Medicaid Services (CMS) has released results from year one of its Next Generation ACO model, revealing that 61 percent of program participants were able to earn shared savings last year.

One Healthcare RCM Leader Shares his Perspectives on Navigating the Shifting Landscape

October 16, 2017  |  Heather Landi
article
Brian Sanderson, managing principal of Crowe Horwath LLP healthcare services group, discusses strategies for CFOs to navigate the shifting landscape around revenue cycle management and reimbursement.

Analysis: Track 1 ACOs Set for Positive MIPS Payment Adjustments

October 12, 2017  |  Rajiv Leventhal
news
An analysis by the National Association of Accountable Care Organizations revealed that 2017 Track 1 ACOs are likely to score well above the MIPS performance threshold, and most above the MIPS exceptional performance threshold.

Survey: 73 Percent of Physicians Prefer Fee-for-Service Models

October 12, 2017  |  Heather Landi
news
A survey of 980 physicians by New York City-based Bain and Company, a management consulting firm, found resistance among physicians to the transition to value-based care and payment models, and 60 percent said it will be more difficult to deliver high-quality...

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