News Clips
Forbes: (7/26) – Former U.S. Senate Majority Leader Bill Frist highlights lessons learned from the past decade of work by the CMS Innovation Center: 1) voluntary models don’t work; 2) having multiple bundles and a separate alternative payment model (APM) for each specialty group has not been the right approach; 3) adding incentive funding on top of payments hasn’t worked (e.g., adding the Per Member Per Month incentive); and 4) accurate benchmarking—vital in value-based care and measuring outcomes—is really hard to do effectively.
Managed Healthcare Executive: (7/25) – The author of this article highlights three strategies to help ACOs achieve more savings: 1) get the data needed to identify cost drivers and reveal clinical improvements; 2) optimize specialty care by sharing data and creating collaborative projects between primary and specialty practices; and 3) optimize specialty care by sharing data and creating collaborative projects between primary and specialty practices.
New York Times: (7/24) – This article notes that President Biden has assembled the most aggressive antitrust team in decades, stacking his administration with legal crusaders as it prepares to take on corporate consolidation and market power with efforts that could include blocking mergers and breaking up big companies.
Managed Healthcare Executive: (7/23) – Creating strong provider and payer relationships is critical to successful value-based care arrangements. By partnering with a payer who is equipped with data-focused analytics that can identify the holistic needs of the patient, providers can better address the capabilities, staffing and infrastructure needed to effectively transition from fee-for-service to value-based care arrangements.
Kaiser Family Foundation: (7/22) – In this op-ed, Kaiser Family Foundation President Drew Altman argues that President Biden’s Executive Order on Promoting Competition in the American Economy could lead to new efforts to control health costs if the Administration and Congress respond with measures to stem consolidation in the healthcare industry and promote competition to drive down prices.
Skilled Nursing News: (7/22) – Within the context of a skilled nursing facility, ACOs have been a contentious program, with some operators considering starting their own ACOs after the initial push for Medicare Advantage and value-based models neglected to include SNFs in the conversation. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) expressed disappointment that the recently introduced Value in Health Care Act treats skilled nursing providers as “contractors” rather than “dynamic participants.”
Becker's Hospital Review: (7/21) – Matt Eyles, President and CEO of AHIP, recently spoke with Becker's about President Biden's recent Executive Order targeting health care consolidation, and the transition to value-based care. He believes that COVID accelerated the transition to value-based care, however he says a truly interoperable healthcare system is needed for full implementation of value-based care models.
Modern Healthcare: (7/21) – Hospitals backed CMS' plan to halt the controversial phase-out of the inpatient-only list, a group of services that Medicare will only pay for if they're done in the inpatient setting due to their medical complexity. They also supported the agency's decision to walk back the number of services that Medicare allows ambulatory surgical centers to carry out, claiming it was a move forward for patient safety.
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