Health Care Dive

OCTOBER 21, 2021

Officials acknowledged provider concerns that current models are too burdensome and benchmarks too complex, which the innovation center aims to rectify.

Accountable Care 283

Accountable Care Accountability Medicare 283

Fierce Healthcare

APRIL 16, 2024

CVS Accountable Care and inVio Health Network, a collection of more than 600 providers in South Carolina, are partnering to improve care outcomes for 60,000 Medicare beneficiaries. |

Accountable Care 159

Accountable Care Accountability Medicare 159

Fierce Healthcare

JANUARY 29, 2024

In 2024, 50 accountable care organizations are new to the Medicare Shared Savings Program and 71 ACOs renewed participation, according to new numbers released by Centers for Medicare & Medicaid | CMS released new data Monday showing ACO participation in the Medicare Shared Savings Program, with 19 ACOs set to participate in a new payment option, (..)

Accountable Care 276

Accountable Care Medicare Accountability Medicaid 276

HIT Consultant

JANUARY 25, 2024

What You Should Know: The Ohio State University Wexner Medical Center a nd CVS Accountable Care, part of CVS Health® (NYSE: CVS), today announced the creation of an accountable care organization (ACO) to improve the quality of care for Medicare beneficiaries by Ohio State providers in central Ohio.

Medicare 90

Medicare Accountable Care Accountability Quality of Care 90

Health Care Dive

AUGUST 25, 2023

Nearly two-thirds of participating accountable care organizations earned payments for their performance last year, according to the CMS.

Medicare 219

Medicare Accountable Care Accountability 219

Home Health Care

MAY 15, 2022

Accountable care organizations (ACOs) have considerably increased their home-based care arsenals over recent years. That’s according to the Institute for Accountable Care (IAC), which conducted a wide-ranging study on ACOs and home-based care that was released Thursday. Source: Institute for Accountable Care.

Accountable Care 93

Accountable Care Accountability Primary Care Medicare 93

Healthcare ECONOMIST

JULY 21, 2023

The Kaiser Family Foundation (KFF) identifies the Part D drugs on which Medicare spends the most money. In 2021, Medicare Part D covered more than 3,500 prescription drug products, with total gross spending of $216 billion, not accounting for rebates paid by drug manufacturers to pharmacy benefit managers (PBMs).

Medicare 83

Medicare Accountability Medicaid 83

Briggs Healthcare

JANUARY 31, 2023

Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA program payments.

Medicare 40

Medicare Accountability Regulations Medicaid 40

Home Health Care

AUGUST 25, 2023

The Medicare Shared Savings Program (MSSP) continues to save Medicare over a billion dollars annually. And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care.

Medicare 98

Medicare Accountable Care Accountability Medicaid 98

Fierce Healthcare

DECEMBER 13, 2023

A jump in claim delays and denials is “wreaking havoc on providers’ revenue cycle performance” and contributing to health systems’ “volatile” accounts receivable and diminishing cash reserves, acco | More frequent pushback from commercial and Medicare Advantage payers is complicating patient self-pay collections and, ultimately, undermining the revenues (..)

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Accountability Medicare Hospitals 327

Healthcare It News

MARCH 30, 2022

Department of Health and Human Services Office of Inspector General released a study examining how Medicare beneficiaries used telehealth during the first year of the COVID-19 pandemic. "Telehealth was critical for providing services to Medicare beneficiaries during the first year of the pandemic," read the report.

Medicare 251

Medicare Medicaid Integration Quality of Care 251

Health Care Dive

JANUARY 24, 2023

Rush University will be the only Chicago-area academic medical center participating in CVS’ first accountable care organization in ACO REACH.

Medicare 243

Medicare Accountable Care Accountability 243

Home Health Care

NOVEMBER 7, 2023

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. million Medicare fee-for-service beneficiaries are assigned to an ACO. Currently, roughly 13.2 We’d like to try it that way.’

Medicare 109

Medicare Accountable Care Home Care Accountability 109

Fierce Healthcare

NOVEMBER 29, 2023

Accountable care organizations do not positively influence treatment and outcomes for chronic mental health conditions for Medicare patients, according to a study in Health Affairs. | A new study pours water on the belief that ACOs are well-suited to handle chronic mental health conditions its patients experience.

Accountable Care 297

Accountable Care Patient Experience Accountability Medicare 297

Healthcare ECONOMIST

NOVEMBER 29, 2023

Just this year a majority of Medicare beneficiaries enrolled in a Medicare Advantage plan. While these plans are popular with patients, I recently wrote that some rural providers are refusing to accept Medicare Advantage due to low reimbursement.

Medicare 74

Medicare Hospitals Accountability Doctors 74

Fierce Healthcare

MARCH 19, 2024

The Centers for Medicare & Medicaid Services (CMS) has announced the ACO Primary Care Flex Model (ACO PC Flex Model), allowing eligible accountable care organizations to treat people with with | Accountable care organizations are largely supportive of CMS' new primary care model released Tuesday, they wish the agency would broaden its scope (..)

Primary Care 159

Primary Care Accountable Care Accountability Medicaid 159

p3care

NOVEMBER 25, 2020

In the last quarter of 2020, CMS (Centers for Medicare & Medicaid Services) announced the performance scores for clinicians of QPP MIPS 2019 on its official site. It accounts for quality healthcare services, that CMS recognizes and rewards for. Check Points for Performance Review.

Medicare 238

Medicare Accountability Doctors Medicaid 238

Fierce Healthcare

JUNE 8, 2023

Phase 1 enrollment in the Medicare Shared Savings Program (MSSP) for 2024 is currently underway, and recent reforms hold promise in attracting new providers into accountable care.

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Accountable Care Accountability Medicare 263

Health Care Dive

DECEMBER 6, 2023

The beleaguered insurer will leave the accountable care program at the end of the 2023 performance year following disappointing results in Medicare direct contracting.

Accountable Care 249

Accountable Care Accountability Medicare 249

Healthcare It News

MARCH 4, 2022

Medicare spends nearly $60 billion on post-acute care annually. Why do you suggest that care coordination with post-acute providers will become more critical than before to support the rise of value-based care? What needs to happen? Post-acute care is a key part of the care continuum and a significant component of healthcare spend.

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Accountable Care Accountability Physical Therapy Nursing 212

Health Care Dive

DECEMBER 9, 2022

Accountable care organizations' net savings rates ranged from -29.4% in the 2021 Global and Professional Direct Contracting Model.

Accountable Care 241

Accountable Care Medicare Accountability 241

Home Health Care

AUGUST 1, 2022

Federal watchdogs reported the Centers for Medicare & Medicaid Services (CMS) has not collected the near-$500 million in Medicare overpayments that were found in audits over a two-year period beginning in 2014. The post CMS, OIG Disconnect Highlighted In Medicare Overpayments Report appeared first on Home Health Care News.

Medicare 105

Medicare Medicaid Accountability 105

NASHP

SEPTEMBER 5, 2023

On August 29, the Centers for Medicare & Medicaid Services (CMS) announced the first 10 prescription drugs that will be subject to negotiation for Medicare under the Inflation Reduction Act (IRA). CMS will publish the MFPs on September 1, 2024, and they will be effective on January 1, 2026 for all purchases under Medicare Part D.

Medicare 74

Medicare Accountability Medicaid 74

Health Care Dive

AUGUST 15, 2023

Regulators lowered enrollment minimums for accountable care organizations in the program, which allows providers to form groups to manage care and costs for fee-for-service Medicare enrollees.

Accountable Care 230

Accountable Care Regulations Accountability Medicare 230

Fierce Healthcare

FEBRUARY 21, 2024

The blueprint set forth by Massachusetts accountable care organizations to improve population health metrics and reduce costs can be applied to New York, after Centers for Medicare & Medic | New York's section 1115 waiver allocates $500 million toward social care networks to connect community health workers with local organizations.

Accountable Care 159

Accountable Care Population Health Accountability Medicare 159

Health Care Dive

JULY 8, 2022

Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.

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Accountable Care Accountability Medicare 329

Sheppard Health Law

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. 3d 1, 18 n.19

Medicare 105

Medicare Medicaid Accountability Integration 105

Healthcare It News

APRIL 5, 2024

Based on its initial investigation, the following information may have been accessed by hackers: name, address, birth date, email, telephone number, marital status, Aboriginal status, Medicare number, referring doctor, and type of diabetes.

Medicare 269

Medicare Hospitals Accountability Doctors 269

NASHP

AUGUST 21, 2023

The National Academy for State Health Policy (NASHP) is pleased to announce a new initiative to work with states to strengthen oversight and accountability of managed long-term services and supports (MLTSS) plans, with a particular focus on payment strategies. To get updates about this opportunity, sign up for NASHP’s weekly newsletter.

Accountability 52

Accountability Medicaid Medicare 52

Fierce Healthcare

AUGUST 24, 2023

The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) has saved a net $1.8 billion in 2022 for accountable care organizations, which is th | Accountable care organizations saved a net $1.8

Accountable Care 130

Accountable Care Accountability Medicare Medicaid 130

Home Health Care

AUGUST 30, 2021

CommonSpirit Health carved out $136 million in savings to Medicare for 2020, while also improving overall outcomes for hundreds of thousands of beneficiaries, the company recently announced. CommonSpirit Health is a participant in the Medicare Shared Savings Program (MSSP), which began back in 2012 after being designed by the U.S.

Medicare 116

Medicare Rehabilitation Home Care Accountable Care 116

Sheppard Health Law

SEPTEMBER 28, 2023

The Centers for Medicare & Medicaid Services (“CMS”) released the final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”) on January 30, 2023. MAOs will be required to remit improper payments identified during RADV audits in a manner specified by CMS.

Medicare 52

Medicare Accountability Medicaid Doctors 52

HIT Consultant

JANUARY 26, 2023

Mighty Health is the the first all-in-one daily health program designed for adults ages 50 and up—covers more than 9 million Americans nationwide through partnerships with leading Medicare Advantage and commercial health plans. The app has supported more than 200,000 individuals to date, with exciting plans for expansion and new offerings.

Medicare 85

Medicare Accountability Doctors Healthcare 85

HIT Consultant

JUNE 2, 2022

What You Should Know: – CareMax , a tech-enabled provider of value-based care to seniors announced an agreement to acquire the Medicare value-based care business of Steward Health Care System for a combination of cash and stock. – CareMax will pay $25 million in cash and issue 23.5

Medicare 95

Medicare Primary Care Quality of Care Accountability 95

Healthcare ECONOMIST

JANUARY 18, 2022

An interesting article in Modern Healthcare reviews some discussion at a recent Medicare Payment Advisory Commission (MedPAC) meeting. The first issue is that the pool of fee-for-service Medicare beneficiaries is shrinking, at least on a relative basis.

Accountable Care 56

Accountable Care Accountability Medicare Healthcare 56

HIT Consultant

NOVEMBER 21, 2023

a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year. What You Should Know: NextGen Healthcare, Inc.

Medicare 52

Medicare Population Health Accountable Care Quality of Care 52

Sheppard Health Law

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

Medicare 52

Medicare Accountable Care Primary Care Accountability 52