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CMS: 93% of Clinicians Get Positive Payment Adjustments for MIPS Year 1

November 8, 2018  |  Rajiv Leventhal, Managing Editor
news
Ninety-three percent of MIPS-eligible clinicians received a positive payment adjustment for their performance in 2017, and 95 percent overall avoided a negative payment adjustment.

HHS Secretary Azar: HHS Is Planning New Mandatory Bundled Payment Models

November 8, 2018  |  Heather Landi, Associate Editor
news
CMS is revisiting mandatory bundled payment models, possibly for radiation oncology and cardiac care, according to Health and Human Services Secretary Alex Azar, which signals a strategic change in the Trump Administration’s policy about bundled payment...

Dr. Sanjay Gupta’s Heartening Speech at CHIME18 Should Inspire U.S. Healthcare Leaders

November 6, 2018  |  Rajiv Leventhal, Managing Editor
commentary
Perhaps we can use the story of the Tsimane tribe to push ourselves to develop a greater understanding of why we spend so much money on healthcare and don’t have the results to show for it.

Healthcare Leaders Praise Telehealth Advancements, Delayed E&M Coding Changes in Recent CMS Rule

November 5, 2018  |  Heather Landi, Associate Editor
article
Starting in 2019, for the first time, CMS will reimburse providers for virtual check-ins with patients, regardless of the patient’s location—a move that drew praise from many healthcare leaders.

BREAKING: CMS Publishes CY 2019 Physician Fee Schedule/QPP Final Rule

November 1, 2018  |  Heather Landi, Associate Editor
article
Late in the afternoon on Thursday, Nov. 1, CMS published the Physician Fee Schedule and Quality Payment Program final rule for 2019, which encapsulates the MIPS and Advanced Payment Models.

HIT Policy Winds Get Stronger as CMS, ONC Regulations Set to Drop Any Day

November 1, 2018  |  Rajiv Leventhal, Managing Editor
article
The calendar has now turned to November as health IT stakeholders continue to anxiously await regulations from federal health agencies, some of which are sure to come in the next 60 days.

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.

CMS Announces 1,300 Participants for New BPCI Advanced Initiative

October 10, 2018  |  Rajiv Leventhal, Managing Editor
article
CMS has announced that nearly 1,300 hospitals and physician group practices have signed agreements with the federal agency to participate in the Administration’s BPCI Advanced model.

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

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.

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

Seema Verma’s Big Picture: Tough Love, ACO Acceleration, Interoperability, and Consumer Empowerment?

August 29, 2018  |  Mark Hagland
commentary
Will CMS Administrator Seema Verma’s strategy of pushing hard on providers around ACO development and interoperability help to accelerate the shift to value-based healthcare—or will it backfire?

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.

At the SHIEC Annual Conference, National Coordinator Rucker Offers a Cautious Opening Keynote

August 20, 2018  |  Mark Hagland, Editor-in-Chief
article
Donald Rucker, M.D., National Coordinator for health IT, offered attendees at the 2018 SHIEC Annual Conference a cautious overview of some of the current issues around interoperability, burden reduction, and TEFCA

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

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?

BREAKING: CMS Proposes Dramatic Changes with Aim to “Modernize Medicare and Restore Doctor-Patient Relationships”

July 12, 2018  |  Rajiv Leventhal
article
CMS today proposed changes that the agency believes will “fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their EHRs to document clinically meaningful information.”

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

Researchers Find a Bundle of Complications Around Bundled Payment Outcomes

June 14, 2018  |  Mark Hagland
commentary
An article published in the current issue of Health Affairs uncovers some of the complexities of mandatory and voluntary bundled payment programs, and some of the implications for their policy and payment future

CMS Hits MIPS Participation Goal for Year One

June 4, 2018  |  Rajiv Leventhal
news
According to CMS Administrator Seema Verma, 91 percent of all Merit-based Incentive Payment System (MIPS)-eligible clinicians participated in the first year of the Quality Payment Program (QPP), exceeding the agency’s internal goal.

Rethinking Observation Stays and Readmissions: Experts Study the Issue

May 31, 2018  |  Mark Hagland
commentary
As medical researchers writing in The New England Journal of Medicine are documenting, shifting some patients from normal inpatient stays to observation stays, is turning out to be a far more complicated proposition than meets the eye

Karen DeSalvo Joins MedPAC as New Member

May 30, 2018  |  Rajiv Leventhal
news
Five new members have been added to the Medicare Payment Advisory Commission (MedPAC), including former National Coordinator for Health IT, Karen DeSalvo, M.D., the Government Accountability Office (GAO) announced.

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

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

GAO: Just 4 of 37 CMMI Payment Models Have Met Goals around Cost, Quality

May 11, 2018  |  Rajiv Leventhal
news
CMMI, created to test new and cost-effective approaches for delivering and paying for healthcare, has partially met its goals, while just four out of the innovation center’s 37 alternative payment models have actually achieved lower spending and higher quality.

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

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