Revcycle Intelligence: (9/28) – A report from Insights by Xtelligent Healthcare Media revealed that private payers are more likely than public payers to participate in value-based reimbursement models. Public payers were less likely to be involved in heavy, risk-based reimbursement models compared to private plans, despite knowing the impact VBC would have on their organization’s financial health.
Fierce Healthcare: (9/28) – With the future of the ACA at the center of the new SCOTUS pick, experts are chiming in about how VBC could be impacted should the ACA be struck down. VBC will likely be safe, largely due to efforts by private payers to accelerate adoption of VBC in recent years.
OSHPD: (9/28) – OSHPD awarded 86 primary care residency programs $35 million in grants to expand health care access to Californians most in need. This initiative funds institutions that train primary care health professionals to provide care in medically underserved areas of the state.
Street Insider: (9/28) – In 2019, 75 percent of Premier Population Health Management Collaborative (PHMC) ACOs participating in the MSSP generated savings for Medicare. Of these ACOs, 44 percent performed well enough to qualify for shared savings payments from Medicare.
Delaware Public Media: (9/27) – Delaware is launching four ACOs to serve Medicaid beneficiaries in order to optimize care delivery and eliminate health care disparities in this population. The Delaware Department of Health and Social Services approved Aledade to launch its ACO for Medicaid patients.
Becker’s Healthcare: (9/25) – Following the release of the CMS 2019 results from the Medicare Shared Savings Program ACOs, Becker’s interviewed six executives from ACOs that earned some of the most shared savings to share strategies and best practices that led to positive results.
Benefits Pro: (9/25) – The House passed the Competitive Health Insurance Reform Act (HR1418), which would repeal the McCarran-Ferguson antitrust exemption for health insurance companies and curb the rate of consolidation in the health care industry.
Health Affairs: (9/25) – Health Affairs proposed a new “PPE” - the combined efforts of Public health, Primary care, and Health equity (PPE) – as a means of equipping communities with the tools, plans, and knowledge to thrive and providing a path toward COVID-19 recovery.
Fierce Healthcare: (9/24) – As cold and flu season approaches, primary care practices are experiencing staffing shortages and disruptions to primary care funding as a result of COVID-19. Equipment shortages pose another threat to primary care, as practices reported difficulty obtaining COVID-19 supplies, PPE, and supplies for flu season.
Healthcare Dive: (9/23) – A survey conducted by the Larry A. Green Center and the Primary Care Collaborative found that 35 percent of primary care physicians say revenue and income are still significantly lower than they were prior to COVID-19 and are calling for more federal aid. However, a third of physicians said their financial picture was slowly improving.
ThinkAdvisor: (9/23) - Proposed IRS regulations (REG-109755-19) may have the potential to end HSA-Direct primary care combinations. The regulations define direct primary care as a form of insurance, not a service, meaning it would not satisfy the criteria as a high-deductible plan necessary to qualify for an HSA and would therefore prohibit patients with direct primary care from accessing an HSA.
Revcycle Intelligence: (9/22) – A new survey confirms growing concern among ACOs that many are unlikely to meet rising participation thresholds for MACRA’s Advanced APMs in 2021, with more than 96 percent of ACOs reporting that they would not meet the 2021 thresholds passed on their performance in 2020 and would therefore not receive the incentive payment during the corresponding payment period.
Revcycle Intelligence: (9/21) – The economic fallout and devastating financial losses caused by the COVID-19 pandemic could accelerate acquisitions of independent practices. Shifting to value-based contracts may help independent practices pivot, generate value, and remain independent in the future.
Revcycle Intelligence: (9/21) – CMS finalized two alternative payment models for specialty care – the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model and the Radiation Oncology (RO) Model. These models will alter how specialists in Medicare get paid by tying reimbursement to quality metrics.
Primary Care Collaborative: (9/21) – A new report from Milbank provides insight for designing prospective payment for primary care and payment design considerations.
Modern Heathcare: (9/19) – Capitated payment models present an opportunity for practices to treat patients in the best way possible while also having a dependable revenue stream when patient visits plummet, like with COVID-19. However, logistical hurdles, regulations, and existing insurance contracts must be considered when entering into these arrangements.
Modern Healthcare: (9/19) – Rep. Dan Crenshaw (R-TX) reflected on the concept of direct primary care as a modern approach to personalized health care. Crenshaw will soon introduce the Direct Primary Care for America Act to expand and normalize access to the direct primary care model.