News Clips
RevCycleIntelligence: (5/2) – The CMS Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model reduced Medicare fee-for-service episode payments for both surgical and medical episodes. CMS launched the BCPI Advanced Model in October 2018, building upon the original BCPI initiative. he model aims to test if linking payments for an episode of care can reduce Medicare spending while maintaining or improving care quality.
Modern Healthcare: (5/2) – Large not-for-profit health systems are recording investment income windfalls that are offsetting significant operating losses. St. Louis-based Ascension recorded a $640.1 million operating loss on $19 billion in revenue through the first nine months of its 2022 fiscal year. Nearly $900 million in non-operating income, $736.4 million of which was attributable to investment income, more than offset those losses. That was down from nearly $4.5 billion in non-operating gains in the same prior-year period.
Health Affairs: (5/2) – Vertical integration in health care has recently garnered scrutiny by antitrust authorities and state regulators. Vertical integration and joint contracting with small and medium health systems rose from 19.5 percent in 2013 to 32.8 percent in 2017 for primary care physicians and from 26.1 percent to 37.8 percent for specialists. We found that vertical integration and joint contracting led to price increases from 2013 to 2017, from 2.1 percent to 12.0 percent for primary care physicians and from 0.7 percent to 6.0 percent for specialists, with the greatest increases seen in large health systems.
MedCity News: (5/2) – Health systems are prioritizing efforts to improve interoperability between EHRs and aggregate patient data for a more complete picture. By demand and necessity, EHRs and other vendors are following suit. The government is also helping the process by adopting new standards like the Fast Healthcare Interoperability Resources (FHIR) that lays out how healthcare information can be exchanged. But full interoperability and data standardization remain the holy grail: mysterious and elusive.
Fierce Healthcare: (4/29) –The recent scuffle over the Direct Contracting model should push providers and regulators to do a better job of showcasing the importance of value-based care, a top Biden administration official said. Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler spoke during the National Association of Accountable Care Organizations’ (NAACOS) spring meeting on the agency's strategy for improving participation among providers in value-based care.
Healthcare Dive: (4/29) – Controversy around a direct contracting model the Biden administration rebranded and redesigned earlier this year following pressure from progressive Democratic lawmakers and single-payer advocates was excessive and not based in fact, according to some members of the accountable care community. NAACOS felt these concerns were “very false and misleading,” said David Pittman, NAACOS senior policy adviser, at NAACOS spring conference. “If politics could kill an ACO model, that would be devastating.”
AJMC: (4/29) – At the opening session of the NAACOS spring conference, Center for Medicare Director Dr. Meena Seshamani, offered insights on how the Biden administration plans to improve alignment between Medicare, models, and the organizations. Creating synergy between CMS and CMMI to align models and allow for upscaling of successful models is also top of mind for Seshamani.
RevCycle Intelligence: (4/29) – Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. This article provides an overview of those programs.
RevCycleIntelligence: (4/28) – Value-based payment models that shared five-year expected savings offered stronger incentives for clinicians to implement preventive interventions for postpartum depression compared to models that offered shared savings over just one year. Most value-based payment models offered shared savings based on reductions in the total cost of care, which represents how much was spent over the episode or the past year.
Fierce Healthcare: (4/28) – The Biden Administration wants to change how benchmark payments to accountable care organizations are calculated to make it easier for providers in the Medicare Shared Savings Program (MSSP) to qualify for savings. CMS leaders outlined several changes they are pursuing to get more providers involved in value-based care in an article in The New England Journal of Medicine.
|