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Is the Discourse Over the MSSP Program Teetering Towards Potential Conflict?

September 21, 2018  |  Mark Hagland
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

At the Health IT Summit in Boston, One ACO’s Data-Facilitated Journey Into Value

August 7, 2018  |  Mark Hagland
article
What does it mean for an organization to pursue a data-facilitated journey into value-based care? Bill Gillis, CIO of the Beth Israel Deaconess Care Organization, shared his learnings and perspectives on that subject, at the Health IT Summit in Boston

BREAKING: CMS Finalizes “Promoting Interoperability” Rule

August 2, 2018  |  Rajiv Leventhal
article
Just three months after issuing a proposal, the Centers for Medicare & Medicaid Services (CMS) has finalized a rule late this afternoon that will overhaul the meaningful use program with a core emphasis on advancing health data exchange among providers.

Can Blue Cross of North Carolina Help to Reshape Its State’s Healthcare Landscape?

July 31, 2018  |  Mark Hagland
commentary
Remarks made by Patrick Conway, M.D. this spring point to some of the opportunities—and profound challenges—facing the shift towards a value-based healthcare system in North Carolina—and the challenges facing health insurers attempting to stimulate that change

At BIDCO, a “Pharmacy First” Approach to Population Health is Driving Promising Results

July 31, 2018  |  Heather Landi
article
Leaders at Beth Israel Deaconess Care Organization deployed a unique “pharmacy first” approach specifically to its Rising Risk Management program with the aim of achieving improved health outcomes in months, not years.

In Virginia, Centra Health Surges Ahead in its IT-Based Push to Value

July 25, 2018  |  Rajiv Leventhal
article
Two of the health system’s executive leaders recently spoke with Healthcare Informatics about Centra Health’s value-based care journey and how IT is playing a key role.

Adam Boehler Tapped by Azar to Serve as Senior Value-Based Care Advisor

July 19, 2018  |  Rajiv Leventhal
news
Adam Boehler, currently director of CMMI, has also been named the senior advisor for value-based transformation and innovation, HHS Secretary Alex Azar announced.

Has the Value-Based Care Train Stalled?

July 19, 2018  |  Rajiv Leventhal
commentary
When pondering the question of if the value-based care train has stalled, the answer will depend on which side of the healthcare stakeholder table you are asking—payers or providers.

Healthcare Leaders React to CMS’ 2019 QPP Proposed Rule and E&M Coding Changes

July 18, 2018  |  Heather Landi
article
Some health IT industry groups have voiced concerns that the CMS proposals, specifically in its proposed rule for the third year of the Quality Payment Program, will undermine efforts to move Medicare provider payment to value.

Value-Based Care Shift Has Halted, Study Finds

July 17, 2018  |  Rajiv Leventhal
news
A new study of 451 physicians and health plan executives suggests that progress toward value-based care has stalled. In fact, it may have even taken a step backward over the past year, the research revealed.

Aligning Incentives in the Forward Evolution Around Value-Based Payment: Major Obstacles Cited

July 16, 2018  |  Mark Hagland
commentary
The implications of a recent HFMA-sponsored analysis of value-based healthcare are many—and challenging, for the pioneers of VBP in new payment models in U.S. healthcare

New Research Reveals MIPS Confusion Among Physicians

July 10, 2018  |  Rajiv Leventhal
article
A survey of internal medicine physicians has revealed low levels of familiarity with the Merit-based Incentive Payment System (MIPS), with some respondents also believing that MIPS requirements could lead to unintended consequences.

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