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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

Report: Complex and Rapidly Changing Payment Models Challenge Physician Practices

October 26, 2018  |  Heather Landi, Associate Editor
news
Physician payment models are becoming more complex and the pace of change is increasing, creating challenges for physician practices that might hamper their ability to improve the quality and efficiency of care despite their willingness to change, according to a...

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...

Report: 34 Percent of Healthcare Payments in 2017 Tied to APMs

October 22, 2018  |  Heather Landi, Associate Editor
news
One-third (34 percent) of total U.S. health care payments were tied to alternative payment models (APMs), such as shared savings/risk arrangements, bundled payments, or population-based reimbursements, in 2017, up from 23 percent in 2015, according to a report...

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.

Are Disruptive Forces in U.S. Healthcare Accelerating Now? Notes on the Now-Approved CVS-Aetna Deal

October 10, 2018  |  Mark Hagland
commentary
The Department of Justice’s approval Wednesday of the CVS-Aetna merger signals a new phase in the healthcare business world—and it’s time for patient care executives to rethink the meaning of competition—and of market disruption

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

MGMA Survey: Medical Group Practices Cite Increased Burden from Regulatory Demands, EHRs

October 4, 2018  |  Rajiv Leventhal, Managing Editor
news
Nearly nine in 10 medical group practice leaders have said that the overall regulatory burden on their organization has increased over the past year, according to a new survey from the MGMA.

Managing the Consumer Data Deluge

October 2, 2018  |  Joe Marion, Industry Voice
commentary
In-home monitoring and diagnostic devices are likely to create substantial new diagnostic data to manage

At the Raleigh HIT Summit, Mission Health’s CQO Shares About the Quality Journey

October 2, 2018  |  Mark Hagland
article
At the Health IT Summit in Raleigh, Mission Health CQO Chris DeRienzo, M.D. discussed the challenges—and the accomplishments—in his organization’s continuous performance improvement journey

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

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 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.

Humana’s CMO Speaks of the “Bold Goal” Embedded in the Company's Population Health Work

September 14, 2018  |  Heather Landi, Associate Editor
article
Roy Beveridge, M.D., Humana’s chief medical officer, shares his perspectives on the drive to value-based care, population health and addressing social determinants of health.

New Healthcare Alliance Launches APM for Addiction Recovery

September 12, 2018  |  Rajiv Leventhal, Managing Editor
news
A national multi-sector alliance of healthcare stakeholders has announced the creation of the Addiction Recovery Medical Home (ARMH) model.

The Ongoing Exploration for Artificial Intelligence’s Best Use in Healthcare: One Expert’s Viewpoint

September 12, 2018  |  Rajiv Leventhal, Managing Editor
article
One of the biggest “buzz terms” in healthcare and health IT is undoubtedly artificial intelligence, or AI, but there are still plenty of questions and debate on how AI can best be leveraged to lower costs.

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.

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...

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.

Is it Fair to Question CMS’ Agenda for Releasing ACO Results?

September 4, 2018  |  Rajiv Leventhal, Managing Editor
commentary
There is much debate on how one-sided risk ACOs are performing as new CMS data has been released

Top Ten Tech Trends 2018: Are the Lines Between Provider and Payer Organizations Beginning to Blur? To Some, That Would be Progress

September 4, 2018  |  Mark Hagland, Editor-in-Chief
article
As physician-based and hospital-based organizations plunge further into risk-based contracting, managing the contracts and the processes is turning out to be highly challenging for everyone.

Industry Groups Urge CMS to Reform Stark Laws, HHS Considers Reforming Anti-Kickback Statute

August 31, 2018  |  Heather Landi, Associate Editor
news
On June 25, the Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) for public input on how to address any undue regulatory impact and burden of the physician self-referral law, also known as the Stark Law.

MSSP 2017 ACO Results Touted by NAACOS, Mostashari

August 30, 2018  |  Rajiv Leventhal, Managing Editor
news
The Centers for Medicare & Medicaid Services (CMS) today released results for how the 472 Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) performed in 2017.

The First 3 Things ACOs Should Do with Their Data

August 28, 2018  |  Aaron Elias, Industry Voice
article
New ACOs are inundated with many activities, from strategic decisions to technical requirements, but managing and using data should also rank highly on one's list of priorities.

Next Generation ACO Model Saves $62M in First Year, CMS Reports

August 28, 2018  |  Heather Landi, Associate Editor
news
The first cohort of ACOs in the Next Generation model generated net savings to Medicare of approximately $62 million while maintaining quality of care for beneficiaries for the 2016 performance year, according to a new evaluation report released by CMS.

Announcing Next Gen ACO Results, CMS Administrator Verma Makes the Case for Moving ACOs to Two-Sided Risk

August 27, 2018  |  Heather Landi, Associate Editor
article
During a webinar, CMS Administrator Seema Verma touted the results of the Next Gen ACO model as evidence that ACOs succeed under two-sided risk as CMS proposes major changes to MSSP ACO program.

CMS’ MSSP Proposed Changes Slammed by Leading ACO Organization

August 10, 2018  |  Rajiv Leventhal
article
The National Association of ACOs called CMS’ proposals to redo the MSSP “misguided,” noting that the changes, if finalized, “will upend the ACO movement by creating havoc with a significant overhaul introducing many untested and troubling policies.”

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.

A Pioneering M.D. Leader Shares Insights on Successfully Navigating the Massachusetts Healthcare Market

August 9, 2018  |  Rajiv Leventhal
article
At the Boston Health IT Summit, the veteran healthcare expert dropped in to give attendees an inside look at how her organization has achieved value-based care success

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