Farzad Mostashari: CMS should look to Medicare Advantage to improve accountable care

FierceHealthIT

HHS Secretary Alex Azar has made it clear that the transition to value-based care is one of his priorities. To help meet that goal and support accountable care organizations, he should look to Medicare Advantage for inspiration, say Farzad Mostashari, M.D., and Travis Broome

Health Care for a Typical Working Family of Four in America Will Cost $28,166 in 2018

Health Populi

The $28,166 includes inpatient facility care (e.g., hospitalizations), outpatient facility care (e.g., Note in the second chart that inpatient care is the largest component of medical spending, closely followed by professional services which, together, equals 60% of spending.

OIG: Medicare ACOs have yet to realize full potential of health IT

FierceHealthIT

Medicare accountable care organizations aren't using electronic health records to their potential, a new report shows.

Why It's Time to Embrace Telemedicine

eVisit

I t’s more than 40 years old and was developed as a way to use improvements in communication technology to bring quality medical diagnoses and care to individuals in remote parts of the world. What’s this new thing called Telemedicine? For starters, it’s not new!

ACOs saved Medicare $2.7B to date, outpacing CMS estimates

FierceHealthIT

Accountable care organizations in the Medicare Shared Savings Programs have saved Medicare $2.7 billion to date, including $859 million in 2016, according to a new analysis commissioned by NAACOS. That's $1.1 billion more than CMS estimates

Why hospital associations are dipping their toes into state-based Medicare ACOs

FierceHealthIT

To build scale and drive greater savings, providers in some regions are banding together in statewide Medicare accountable care organizations (ACOs).

Medicaid’s Telehealth Expansion Waiver Changes ACO Restrictions

Telebehavioral Health Institute

For years, the CMS and Medicare have been open to recognizing telehealth. For instance, to date, Medicare has limited its coverage to serving only clients/patients in rural Health Professional Shortage Areas (HPSA). Blog Accountable Care Organizations Behavioral Telehealth Centers for Medicare & Medicaid Services How to Stay Out of Hot Water: Telehealth Documentation! Although telehealth is covered, there are restrictions.

Medicaid’s Telehealth Expansion Waiver Changes ACO Restrictions

Telebehavioral Health Institute

For years now, the CMS and Medicare have been open to recognizing telehealth. For instance, Medicare limits its coverage to rural Health Professional Shortage Areas (HPSA). Blog Reimbursement Strategies: Increasing Authorization & Payment TMHI Certification Program Accountable Care Organizations Centers for Medicare & Medicaid Services How to Stay Out of Hot Water: Telehealth Documentation!

ACOs Lowered Spending in Rural, Underserved Areas

BHM Healthcare Solutions

Medicare Shared Savings Program ACOs can lower Medicare spending in rural areas, suggests a study published in The New England Journal of Medicine. The researchers compared Medicare claims and enrollment data for patients of 41 ACOs in the model.

CMS Reveals New Direction for MSSP Which Adds Risk on ACOs

BHM Healthcare Solutions

CMS announced a “new direction” for the Medicare Shared Savings Program (MSSP) dubbed “Pathways to Success.” The changes will redesign participation options in hopes of encouraging accountable care organisations to take on risk quicker. million Medicare beneficiaries.

ACOs with Multiple EHRs Struggle with IT Health Care Coordination

BHM Healthcare Solutions

ACOs connected by a single EHR were more successful at care coordination, though most also supplement their EHR platform with other tools and technology, according to a report from HHS’ Office of Inspector General. The report is based on an evaluation of six Medicare ACOs.

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Bridges Health Partners, Aetna form managed care partnership in western Pennsylvania

FierceHealthIT

Bridges Health Partners and Aetna have entered into an accountable care agreement for Aetna’s Medicare Advantage members

CMS: ACOs saved $739M in 2018 as new program takes hold

FierceHealthIT

Accountable care organizations generated $739.4 million in net savings in 2018, with physician-led ACOs being the biggest savers, according to the Centers for Medicare & Medicaid Services

CMS Pushes ACOs to Take on Risk with Overhaul of MSSP

BHM Healthcare Solutions

9 that would make sweeping changes to the Medicare Shared Savings Program, including overhauling the way ACOs share in risks and rewards. The proposal would hold ACOs in two-sided models accountable for losses even if they exit midway through a performance year.

ThoughtLeaders: Prognosis for Medicare and Commercial ACOs

E-CareManagement

A number of pundits are citing the systemic failure of ACOs, after additional Pioneer ACOs announced withdrawal from the program – Where do you weigh in on the prognosis for Medicare and Commercial ACOs over the next several years?” Certainly, if we dial back the rhetoric and the expectations for immediate system -wide transformation, we can expect accountable care organizations to make a contribution to incentivizing more efficient care.

Physician-led ACOs generated almost seven times more savings than hospital-led ACOs: Avalere

FierceHealthIT

Physician-led accountable care organizations generated nearly seven times more savings for Medicare last year compared to more high-revenue ACOs typically led by hospitals, a new analysis finds

ACO Lessons Learned: Revisiting the Timing of Downside Risk

E-CareManagement

The editor and publisher of Accountable Care News have been generous in allowing me to republish my article from the November 2014 issue. Care Providers & Care Coordination Health Policy/Reform accountable care ACO capitation Medicare Shared Savings Program

OIG: Medicare ACOs have yet to realize full potential of health IT

Healthcare Guys

Medicare accountable care organizations aren’t using electronic health records to their full potential, a new report shows.

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3 Big Healthcare Trends To Watch in 2015

BHM Healthcare Solutions

The Affordable Care Act has brought a lot of changes to the healthcare industry and one of those changes is a shift from fee-for-service methods of payment to bundled payments.

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Medicare advisers mull altering bonus payments for ACOs

FierceHealthIT

The main Medicare payment advisers to Congress have mulled a proposal to solidify and expand an incentive payment for accountable care organizations (ACOs), which could lead organizations to take on more risk. This week, MedPAC proposed a 5% increase to bonus payments for advance alternative payment models under MACRA

HIMSS19: Verma launches project to open up ACO data

FierceHealthIT

CMS Administrator Seema Verma said accountable care organizations should be able to easily retrieve Medicare Part A, Part B, and Part D claims data for their beneficiaries

CMS guidance aims to ease access to nursing home waivers for ACOs

FierceHealthIT

The Centers for Medicare & Medicaid Services is making it easier for accountable care organizations that accept downside risk to obtain waivers for a rule that requires a three-day inpatient stay before a referral to a nursing home

CMS finalizes ACO overhaul, shortening pathway for financial risk

FierceHealthIT

CMS finalized substantial changes to the Medicare Shared Savings Program (MSSP), an overhaul that will truncate the time that Accountable Care Organizations can remain in one-sided risk models.

“Pathways to Success,” an Overhaul of Medicare’s ACO Program

CMS.gov

“Pathways to Success,” an Overhaul of Medicare’s ACO Program. Administrator, Centers for Medicare & Medicaid Services. Medicare Parts A & B. Pathways to Success,” an Overhaul of Medicare’s ACO Program. Today the Trump Administration announced our overhaul of the program for Accountable Care Organizations, or “ACOs,” in Medicare. ACOs serve a large number of Medicare beneficiaries – over 10.4

Congressional Leaders Voice Concerns about Stability of ACOs with Proposed MSSP Changes

Healthcare Informatics

House of Representatives Ways and Means Committee weighed in on several recently proposed regulations from CMS related to burden reduction, including the agency’s overhaul of Medicare’s Accountable Care Organization (ACO) program In a letter to CMS Administrator Seema Verma, leaders of the U.S.

How to ensure bundled payments coexist with ACOs

FierceHealthIT

Bundled payments and accountable care organizations have emerged as favored alternative payment models within Medicare. According to a blog post in Health Affairs, overlap between the two models could produce unintended consequences

Industry Voices—5 things to know about the Chronic Care Act

FierceHealthIT

Multispecialty medical groups and health systems operating accountable care organizations or participating in Medicare Advantage plans will find some new tools for managing this patient population if they look closely at the provisions of the Bipartisan Budget Act of 2018, which includes the Chronic Care Act

Did Republicans just say they were fine with ‘death panels’ themselves?

Meaningful HIT News

Remember the “death panels” hysteria in 2009 or so when the Affordable Care Act was under development? That idiocy came from language in the ACA that authorized Medicare to pay for voluntary end-of-life counseling. The fear, from the right-wing punditry was that bureaucrats would start to deny care to older, sicker Americans. health reform Healthcare IT Patient Protection and Affordable Care Act politics American Health Care Act Medicare

Telehealth and the CHRONIC Act of 2017 (S. 870)

South Central Telehealth Resource Center

The CHRONIC Act – Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act – passed the U.S. House of Representatives, allows for an expansion of telehealth/telemedicine coverage under the Medicare Advantage Plan B. Medicare Participants.

Ohio Living achieves low readmission rates with telehealth

Healthcare IT News - Telehealth

percent, nearly half of the state’s Medicare average, by introducing telehealth services. In addition, Ohio Living said more than three-quarters of enrolled patients said they agree the telehealth program has given them the opportunity to be more involved in their own care.

Health IT Instrumental in Revitalizing Mental Health, Preventive Care for New Mexico Hospital

Healthcare Guys

Health IT Instrumental in Revitalizing Mental Health, Preventive Care for New Mexico Hospital. If healthcare leaders seriously put their minds to it, implementing new and efficient health IT solutions where they are needed most can play a role in truly transforming how care is delivered.

Bipartisan Budget Deal Expands Funding for Telehealth

American Well

This provision allows Medicare beneficiaries an option by which they may elect to receive in-home dialysis monthly as well as ESRD-related clinical assessments via telehealth services. 50323 – Increasing Convenience for Medicare Advantage Enrollees through Telehealth. This provision states that, beginning in plan year 2020, a new medial assistant plan may be able to provide additional telehealth benefits to Medicare enrollees.

CBO Score Allows CHRONIC Care Act to Pass Hurdle

American Well

A bipartisan group of US Senators recently reintroduced the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (or CHRONIC, for short) Care Act of 2017 (first introduced in 2016 ), intended to improve healthcare outcomes for Medicare recipients living with chronic conditions. To facilitate these improved outcomes, the bill included various new provisions to Medicare. Beginning in 2020, it will expand telehealth coverage under Medicare Advantage Plan B.

RMCHCS integrates Zoeticx healthcare apps to drive revenue with better patient outcomes

Healthcare Guys

This reputation also killed many resident’s spirits, contributing to addiction, joblessness and homelessness, further highlighting the need for behavioral health care in this region. In addition, the Zoeticx app includes other services that Medicare would recommend apart from a checkup.

Hospital Ups Patient Care and Revenue By Integrating Data With AWV, Chronic Care Management and Care Transition Apps

Healthcare Guys

Hospital CEO David Conejo has turned to health information technology in his pursuit of behavioral health care remedies to treat patient addiction while leveraging government insurance changes in Medicare and Medicaid Services (CMS), under the Obama Administration. Rather than traditional acute care services, CMS began to shift its focus on preventive care, identifying a 6:1 cost savings ratio.

How a New Mexico facility is using IT to battle addiction

Healthcare Guys

Rehoboth McKinley Christian Health Care Services. Rehoboth McKinley Christian Health Care Services. Rather than traditional acute care services, the federal programs began to shift its focus on preventive care, identifying a 6:1 cost savings ratio. Value-based care.

12 Ways Telehealth is Saving Small Hospitals

GlobalMed

As community hubs of healthcare, they are tasked with delivering expert medical care across emergency departments, outpatient practices, surgical suites, labs, radiology departments, intensive care units and more. Meet accountable care and risk contracts.

State of the Union Review: Our Healthcare Ecosystem

Medicine and Technology

What are you doing this afternoon? How about listening to a webinar on our heatlhcare ecosystem?

New Mexico Hospital Battles Addiction with Health Information Technology Apps

Healthcare Guys

For many years Northwest New Mexico’s Gallup ranked number one nationally in the number of alcohol-related deaths.This reputation also killed many resident’s spirits, contributing to addiction, joblessness and homelessness, further highlighting the need for behavioral health care in this region.

In McKinley County, NM’s battle against addiction progresses

Healthcare Guys

This reputation also fostered the deaths of many resident’s spirits, contributing to addiction, joblessness and homelessness, further highlighting the need for behavioral health care in this region. McKinley County is the namesake of the assassinated 25th U.S. President William McKinley.