News Clips
Fierce Healthcare: (10/25) – The National Association of ACOs (NAACOS) released a white paper Monday outlining key recommendations on how CMS can use ACOs to help close equity gaps. The paper calls on the Biden administration to develop new quality measures and create bonuses to help ensure accountable care organizations can address health equity.
Fierce Healthcare: (10/25) – Many providers recognize the benefits of tracking social risk factors, but they say lack of integration with workflow and payment systems make widespread adoption challenging. Social risk data also do not tend to live within the electronic health record, but rather in siloed databases or social service systems. Additionally, when physicians notice the impact of social determinants but lack the tools to make a meaningful difference, burnout accelerates. As a result, compensating physicians accordingly and incorporating social determinants into payment models is key to success.
Fierce Healthcare: (10/22) – The Next Generation accountable care organization model, which is being shuttered after this year, saved Medicare $637 million in 2020. The data, released Thursday by CMS, come as ACO advocates want the agency to give organizations more options to take on financial risk. NAACOS’ analysis of performance data showed that the number declined to $230 million after accounting for shared savings paid out to the ACOs.
Modern Healthcare: (10/22) – For years, patients have complained they often do not know how much hospitals charge for healthcare services until they are billed, unlike other commercial products such as gasoline, clothes or housing. But published hospital prices show wide variations in prices — up to eight times — for the same care, demonstrating to advocates that price transparency can help consumers shop for the best prices..
American Medical Association (AMA): (10/22) – The rise of health system and hospital ownership of primary care practices raises policy questions about the survival of independent physician-owned practices. Tis study found that a substantial proportion of Family Practices in 2017–2019 remained in independently owned practice: 81 percent of solo practitioners and 35 percent of Family Practice in practices with 2–5 clinicians. These findings suggest that independent practice is surviving, and that it's incumbent on researchers, payers, and policymakers to better understand their unique contributions and challenges in the effort to improve primary care access, quality, and cost.
Modern Healthcare: (10/21) – Jonathan Blum, principal deputy administrator of CMS, questioned the future of Medicare Advantage payments Thursday, pointing to studies from government watchdogs and experts. "We too are very concerned with the overall trend lines for code growth in the MA program versus the overall fee-for-service program...Should we use a benchmark? Should we try something else going forward for risk adjustment purposes and for overall benchmark purposes?" Blum said.
Fierce Healthcare: (10/21) – Biden administration officials want more information from Medicare Advantage (MA) plans on how key benefits are helping underserved patient populations. Officials with the Centers for Medicare & Medicaid Services (CMS) discussed the need for greater collaboration during a conference this week sponsored by the Better Medicare Alliance. Officials said they want to better understand the impact of incentives in the MA program to address health equity and to spur more participation in the value-based insurance design (VBID) model.
RevCycleIntelligence: (10/20) – A group of healthcare organizations, led by the National Association of ACOs (NAACOS), has asked CMS to provide accountable care organizations (ACOs) with the option to use pre-pandemic years to set Medicare Shared Savings Program (MSSP) benchmarks. Under current CMS policy, ACOs that renew MSSP agreements and new ACOs that enter the MSSP in 2022 will receive benchmarks that are based on spending targets from 2019 to 2021.
MedCity News: (10/20) – Chiquita Brooks LaSure, CMS Administrator, expressed concerns about mandatory models from an equity perspective. The agency leadership has said they are considering making more of its experimental models mandatory rather than voluntary, as this will help generate system-level savings and prevent situations where providers cherry-pick the models in which they participate. However, Brooks LaSure stressed that it is important to ensure that the providers who don’t have the capital or resources to participate in these models are not left out if they are made mandatory.
Modern Healthcare: (10/20) – The Biden administration hopes to increase participation in alternative payment models as a way to save the government money and improve care for beneficiaries. Purva Rawal, chief strategy officer for the Center for Medicare and Medicaid Innovation said the administration wants to "accelerate" the movement to value-based care through Accountable Care Organizations and other models. Rawal specifically mentioned direct contracting models, which allow more types of organizations to participate in risk-sharing arrangements. "That's really our third generation ACO model that we're really building on," Rawal said.
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