February 23rd 2024
While adopting new payment models can come with challenges, there are strategies that can help oncology practices optimize their approaches, said Kathy Oubre, MS, CEO of Pontchartrain Cancer Center.
February 14th 2024
Rob Mechanic: ACOs Are Perfectly Positioned to Better Help High-Need, High-Cost Patients
January 24th 2019The way accountable care organizations are set up makes them a perfect system of care for high-need, high-cost patients who might otherwise fall through the cracks of traditional delivery models, said Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable Care.
Watch
Dr Barbara McAneny on Crafting New APMs and Improving Partnerships Between Physicians and Payers
January 17th 2019There needs to be a more trusting partnership between physicians and CMS and other payers that physicians want to deliver the best care to patients at a lower cost, said Barbara L. McAneny, MD, president of the AMA.
Watch
Alternative Payment Models and Hospital Engagement in Health Information Exchange
January 4th 2019Alternative payment models (APMs) introduce value-based incentives for greater hospital health information exchange (HIE) engagement. We find that APM participation is associated with lower HIE volume and greater HIE diversity, breadth, and depth.
Read More
CJR Program Moderately Decreased Spending Without Increasing Complications
January 4th 2019Hospitals that are participating in Medicare’s mandatory bundled payment model for hip and knee replacements reported a decrease in spending per episode of $812 compared with control hospitals not participating in the Comprehensive Care for Joint Replacement (CJR) program.
Read More
Allison Brennan: Compared With Other Models, ACOs Show Increasingly Positive Results
January 4th 2019With a number of difference payment programs being tested, it’s important to have a sophisticated evaluation of these programs to really understand their impact on quality and cost, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.
Watch
Dr Sibel Blau Explains What the Results of OCM Have Shown
December 31st 2018Results from the first 2 performance periods of the Oncology Care Model (OCM) highlighted areas where Northwest Medical Specialties was doing well and areas it could improve, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.
Watch
Dr Barbara McAneny: It Is Crucial Community Oncology Practices Be Allowed to Thrive
December 30th 2018With the low cost and high quality of community oncology practices and 40% of Americans living in rural areas, the country needs to preserve and allow community practices to thrive, said Barbara L. McAneny, MD, president of the American Medical Association and CEO of the New Mexico Cancer Center.
Watch
HRRP May Have Done More Harm for Patients With Heart Failure and Pneumonia
December 28th 2018The Hospital Readmission Reduction Program was announced as part of the Affordable Care Act and penalized hospitals for higher-than-expected 30-day readmissions. However, new research finds that the policy may have done more harm than good with postdischarge mortality increasing for Medicare beneficiaries hospitalized for heart failure and pneumonia.
Read More
Allison Brennan Outlines Additional Areas of Improvement for Medicare ACOs
December 24th 2018There are additional areas of improvement for Medicare accountable care organizations (ACOs) beyond what was proposed in the Pathways to Success regulation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs (NAACOS).
Watch
Challenges and Opportunities in the Oncology Care Model
December 23rd 2018The practices that have been participating in CMS’ Oncology Care Model have undergone significant practice transformation in order to be successful in the program. However, even after being in the model for 2 years, there are still remaining opportunities for investment.
Read More
CMS Finalizes Overhaul of MSSP With Some Changes to Its Proposed Rule
December 22nd 2018CMS has finalized “Pathways to Success,” its overhaul of the Medicare Shared Savings Program (MSSP) that will push accountable care organizations to assume risk more quickly. The final rule includes some changes to the proposed rule, which was introduced in August.
Read More
Dr Michael Kolodziej Reflects on OCM and What Might Come After
December 19th 2018The Oncology Care Model (OCM) is not a sustainable model, but while it finishes out the 5-year pilot, CMS will likely be fine-tuning bundled payments in medical oncology, said Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc.
Watch
Dr Sibel Blau Discusses Physician, Staff Education Around OCM
December 17th 2018Implementing the Oncology Care Model required educating physicians and staff on a new way to do the work and why the changes were necessary under the new model, explained Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.
Watch
Common Factors Among Successful Practices in the OCM
December 16th 2018Practices participating in the Oncology Care Model have now received performance results for 2 periods, and many practices were surprised that they didn’t perform as well as expected. In general, some of the practices have found it difficult to predict success in the model, but there have been positive results from the OCM.
Read More
OCM PP1 True Up 1/PP2 Initial Reconciliation—Lessons Learned
December 15th 2018CMS recently released the Oncology Care Model (OCM) performance period 1 (PP1) true-up 1 and the performance period 2 (PP2) initial reconciliation. The performance data show some practices may be gaining traction with their success, while others have found it difficult to make progress as CMS continues to refine the payment methodology for the model across performance periods.
Read More
What Dr Jane F. Barlow Sees in the Future for Reimbursement for High-Cost Therapies
December 13th 2018The greatest unknown if which reimbursement model for these high-cost therapies will gain supremacy, explained Jane F. Barlow, MD, MPH, MBA, senior advisor, Center for Biomedical Innovation at Massachusetts Institute of Technology.
Watch
Dr Sibel Blau Outlines Changes to Her Practice to Prepare for OCM
December 6th 2018Years before the Oncology Care Model (OCM) was implemented, Northwest Medical Specialties started preparing by making changes to the personnel in the practice, explained Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.
Watch
Majority of Hospitals Will Receive Incentive Payments in 2019 Hospital VBP Program
December 4th 2018In fiscal year 2019, there will be approximately $1.9 billion in value-based incentive payments available to hospitals in the Hospital Value-Based Purchasing (VBP) Program, which is a budget-neutral program.
Read More
CMS Finalizes New Structure to Move Home Health to Value-Based Payment
November 28th 2018CMS is moving home health agencies away from a volume-based payment model and to a new value-based payment system. The Patient-Driven Groupings Model would focus on patient needs and rely more heavily on patient characteristics in order to pay for home health services.
Read More
Stephen Nuckolls: ACOs Remain the Government's Best Option to Control Healthcare Costs
November 25th 2018The proposed changes to the Medicare Shared Savings Program may put a damper on the accountable care organization (ACO) movement, but ACOs remain the government’s best option for controlling healthcare costs, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.
Watch
Allison Brennan Discusses Impacts of Certain Proposed Changes to the MSSP
November 24th 2018There are some proposed changes to the Medicare Shared Savings Program (MSSP) that may be favorably or not depending on the accountable care organization (ACO) and its situation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.
Watch
Humana's Investment in Holistic, Value-Based Care Improves Care and Health of MA Members
November 23rd 2018Chronic diseases remain a significant challenge for older Americans, and Humana is using a holistic approach, leveraging value-based reimbursement models, to improve health outcomes and quality measures for the insurer’s Medicare Advantage (MA) members, according to a new Humana report, “The Intersection of Health + Care.”
Read More
Dr Barbara McAneny: Success in OCM Seems Like a "Random Event"
November 23rd 2018Practices that had experience with the COME HOME community oncology medical home model didn’t perform any better in the Oncology Care Model (OCM) than other practices, explained Barbara L. McAneny, MD, president of the American Medical Association.
Watch