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
CMS Will Waive MIPS for Doctors Who Agree to More Medicare Advantage Risk
June 29th 2018CMS is launching a demonstration of its Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI), which pushes Medicare Advantage (MA) providers into taking on more risk. The demonstration, which has to be approved and adopted, would waive Merit-based Incentive Payment System (MIPS) requirements for doctors opting into the new program.
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Value-Based Transformation Needed in Post-Acute Care as Population Ages
June 29th 2018With the American population aging, the healthcare system will need to undergo a transformation, HHS Secretary Alex Azar said when he spoke before the Health Care Association/National Center for Assisted Living.
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CMS Clears Oklahoma VBP Plan, but Rejects Massachusetts Formulary Request
June 27th 2018Oklahoma’s Medicaid program is the first to win approval from CMS to negotiate supplemental rebate agreements involving value-based purchasing (VBP) arrangements with drug manufacturers, with the aim of producing extra rebates for the state if clinical outcomes are not reached. Separately, CMS denied an application from Massachusetts requesting the ability to exclude certain Medicaid-covered outpatient drugs through a closed formulary.
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Radiation Oncologists Take to Capitol Hill to Emphasize Importance of Specialty APM
June 26th 2018As radiation oncologists met with policy makers in Congress as part of the 15th annual American Society of Radiation Oncology Advocacy Day, the need for a radiation oncology–specific alternative payment model (APM) was one of the key topics of discussion.
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Value-Based Payment Models Not Yet Reaching Full Potential, Study Says
June 26th 2018A new study from the Healthcare Financial Management Association, Leavitt Partners, and McManis Consulting found that the penetration of value-based payment (VBP) models is not yet enough to generate cost savings and is also not affecting clinical quality outcomes at the market level.
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Hospital-at-Home Bundled Program Associated With Better Clinical Outcomes, Patient Experiences
June 25th 2018Providing an alternative to inpatient care, hospital-at-home care bundled with a 30-day postacute transitional care episode is associated with improved patient outcomes, such as readmissions and emergency department revisits, and ratings of care compared with inpatient hospitalization.
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Report: Value-Based Care Strategies Effective, but Payers Struggle to Roll Them Out Quickly
June 23rd 2018A national study of 120 payers has found that nearly two-thirds of payments are now based on value, and value-based care is helping stakeholders to achieve the triple aim of lower costs, improved health, and better patient experiences.
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Dr Ezekiel Emanuel's "Prescription for Success" to Improve US Healthcare
June 21st 2018At the America’s Health Insurance Plans Institute and Expo, held in San Diego, California, June 20-22, Ezekiel J. Emanuel, MD, of the University of Pennsylvania’s Wharton School and School of Medicine, presented his “prescription for success” for improving healthcare in United States.
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Participation in OCM May Transform Care for Certain Cancer Types More Quickly Than Others
June 20th 2018Physicians participating in the Oncology Care Model now provider care for approximately 21% of Medicare patients with cancer. An analysis from Avalere Health found that those doctors treat some types of cancers more than others.
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Physician Practice Variation Under Orthopedic Bundled Payment
This study demonstrates that variation reduction is an important, but not requisite, component of organizational success under orthopedic bundled payment.
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Physicians Assert Trust in Small Group Practices During Shift to Value-Based Care
June 12th 2018Physician migration from physician-led practices to hospital employment has shifted. While physicians working for a hospital or in a practice with some ownership increased by 32.6% in 2016, independent and physician led group practices reached 72% in 2017, according to a new Black Book report.
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Health Organizations Urge HHS to Recognize MA Providers in MACRA
June 10th 2018Healthcare organizations have sent a letter to HHS, urging it to count physician participation in Medicare Advantage (MA) plans toward participation criteria for the Advanced Alternative Payment Model track of the Quality Payment Program.
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Analysis Compares Characteristics and Baseline Performance of Participants in BPCI and CJR
June 6th 2018A study of baseline characteristics and spending of hospitals participating in Medicare's voluntary and mandatory orthopedic bundled programs found that there were few differences, indicating that mandatory programs could engage more hospitals that otherwise would not have participated in voluntary programs.
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A Place-Based Approach May Help the US Implement Payment Reform
June 1st 2018Although accountable care organizations cover more than 32 million people in the United States, the financial savings have been limited and the outcomes are unknown. Place-based approaches aimed at integrating care, improving population health, and controlling costs may be beneficial to adopt as the United States moves away from mandatory participation in payment reform.
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Results From the Comprehensive Primary Care Initiative Highlight Challenges of Transforming Care
May 30th 2018An analysis of the 4 years of the Comprehensive Primary Care Initiative found slowed growth in emergency department visits, but no significant changes in Medicare spending or claims-based quality of care.
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Dr Charles Saunders: Practices Don't Integrate Technology Well
May 29th 2018In general, practices and health systems don’t do a good job of integrating technology into practice, partly because most of the technology they use isn’t well suited to their needs, explained Charles Saunders, MD, CEO of Integra Connect.
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CMS Introduces Qualified Clinical Data Registries to Help Practices Satisfy MIPS Requirements
May 26th 2018To ease administrative burden, CMS has facilitated the collection and processing of information through Qualified Clinical Data Registries, which collect data on quality measures from providers and transfer the information to CMS, helping practices to satisfy MIPS requirements for quality and value improvement.
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Benchmarking in the Era of Value: the Need for Real-Time Comparative Data
May 23rd 2018As benchmarking is now becoming a part of payment models, practices realize they need comparative data to understand how well they perform relative to their competitors and whether there is room for improvement.
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BCBSA Announces Its Value-Based Care Program Outperforms Other Care Providers
May 23rd 2018Since the launch of the Blue Distinction Total Care program, it has outperformed 96% of industry quality measures in key healthcare quality and patient health metrics, The Blue Cross Blue Shield Association (BCBSA) announced.
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Panelists Provide Insight on What It Will Take to Truly Move to Accountable Care
May 17th 2018So far, the move to accountable care has been promising, but more needs to be done to encourage providers into risk, said panelists at The American Journal of Managed Care®’s Accountable Care Delivery Congress.
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Employers Play an Increasingly Important Role in the Move to Value-Based Care
May 16th 2018Employers may be intimidated by the idea of purchasing healthcare, but they are getting more involved in it and they are in a position to transform the market and promote value-based care, said Suzanne Delbanco, PhD, MPH, executive director of Catalyst for Payment Reform, during her keynote at The American Journal of Managed Care®’s Accountable Care Delivery Congress.
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CMMI Partially Met Targets for Performance Goals Related to Payment, Delivery Reform Efforts
May 10th 2018Since its inception, the Center for Medicare and Medicaid Innovation (CMMI) has implemented 37 models testing healthcare delivery and payment reform. A new Goverment Accountability Office assessment found that CMMI has partially met goals for performance targets.
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