Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System, discusses how Mount Sinai’s accountable care organizations (ACOs) will have to adjust to the proposed CMS Medicare Shared Savings Program (MSSP) changes.
Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System, discusses how Mount Sinai’s accountable care organizations (ACOs) will have to adjust to the proposed CMS Medicare Shared Savings Program (MSSP) changes.
Transcript
Mount Sinai has multiple ACOs. How do you foresee the proposed changes to MSSP potentially affecting the Track 1+ ACO or the other ACOs?
I think for Track 1+ specifically, it actually may not affect us quite as much, because we’re already culturally there in terms of taking risk and how we perceive risk and manage around it. So, I think that’s actually a little easier to get our heads around than, perhaps, our 2 Track 1, no downside risk ACOs, where the scheduling now is off. It’s now compressed in terms of where we were thinking we need to go in terms of risk and how much risk we were planning on taking. So, I think it’s affected them a little bit more.
But it certainly impacts our decisions about timing, because we are growing through a growth phase as a system now, we acquired a new system, they have their own ACO, it has changed so much of our strategy of do we combine our operations, do we combined tax IDs as we’re combining systems or not and when do we do that? All of those things have come into play as a result.
The Supreme Court seems likely to reject a challenge to the abortion pill mifepristone; the FDA is inspecting far fewer pharmaceutical companies conducting clinical research; AstraZeneca has sued to block an Arkansas law that it said would unlawfully expand the 340B program to include for profit-pharmacy chains.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Dupilumab Considered Safe, Effective Treatment for Adolescent, Adult Patients With AD
March 20th 2024These posters both used the GLOBOSTAD study, which demonstrated through patient and physician assessments that dupilumab is a safe and effective treatment for adolescent and adult patients with atopic dermatitis (AD).
Read More
Covered Preventive Services at Risk: V-BID Summit Breaks Down the Braidwood v Becerra Case
March 20th 2024For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
Read More