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Verma Hopes Stark Law Regulatory Update Will Come by Year's End

The CMS administrator says a team is working hard to hammer out details to alleviate concerns that the law can impede value-based care arrangements. Centers for Medicare & Medicaid Services...

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Medicare's 'Primary Care First' Program Has Its Skeptics

The initiative is too focused on cutting hospitalizations and doesn't have enough money for doctors, critics say. This article was published May 29, 2019, by MedPage Today. By Joyce Frieden, News...

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2 Pain Points Strategy Leaders Are Talking About Right Now

Healthcare CEOs are looking to their peers for potential strategies on how to succeed in the midst of the industry's transformation. The challenges facing senior healthcare executives vary from one...

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BCBSMA Chief: 'Controlling Costs and Simultaneously Improving Care is Possible'

Blue Cross Blue Shield of Massachusetts' alternative payment model slowed the rate of medical spending growth and improved patient care. An alternative payment model based on clinical quality, patient...

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Fewer ACOs Join Medicare Shared Savings Program, But More Take Downside Risk

The drop comes in the first enrollment start-date since CMS overhauled the program to hasten ACOs' downside risk. Sixty-six accountable care organizations (ACO) joined the Medicare Shared Savings...

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Stakeholders Rap CMS Mandatory Radiation Oncology Model

Providers raise concerns that the mandatory CMMI payment models will create unnecessary burdens and challenges. The American Hospital Association and other key stakeholders are raising concerns about a...

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'Value' of care was a big goal. How did it work out?

For most of its history, Medicare paid for health care in ways that encouraged more services — whether they improved health or not. Critics called it an emphasis on volume, not value. Pillar:...

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Medicare Shared Savings ACOs Generated $1.7B in Savings in 2018

Of the 548 ACOs that cared for 10.1 million beneficiaries, 66% saved money and 37% saved enough money to earn bonuses. The Medicare Shared Savings Program generated $1.7 billion in total savings in...

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The Reality of Success in Medicare Advantage

Every provider organization must be able to define what success looks like in Medicare Advantage. Effective models include four foundational principles – strategic contracts, accurate coding and...

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HHS Delivers Long-Awaited Stark Law Regulatory Overhaul

The two proposed rules from HHS OIG and CMS aim to make it easier to provide value-based care without running afoul of self-referral and anti-kickback laws. With a pair of proposed regulations, the...

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5-Part Strategy to Create a Population Health Services Organization

In the New Orleans area, LCMC Health is making strides toward value-based care by taking a population health services organization approach to its new clinically integrated network.A New Orleans–based...

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CMS Value-based Purchasing Program IDs $1.9B for Hospitals in 2020

More than 1,500 hospitals will get higher Medicare payments from the program in FY 2020.Hospitals could receive as much as $1.9 billion from the federal government in 2020 under projections put forward...

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What's Really Driving 30-day Readmission Declines?

A Harvard study offers an alternative explanation for declines in hospital readmissions.There's no arguing that 30-day readmissions for certain conditions targeted by a federal initiative to improve...

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CMS Releases Details on 2021 Direct Contracting Models

The agency published an RFA that outlines how the global and professional options will work.Seven months after announcing a package of new value-based payment models to transform primary care, the...

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Congress Looks to Fix ACA's 'Rural Glitch'

The bill would fix a regional calculation that forces accountable care organizations to measure their performance against themselves and disproportionately impacts rural providers.Rural healthcare...

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Mayo's Structured Compensation Model Tackles Gender Pay Inequality

A review of compensation for 2,845 Mayo physicians — including 861 women — affirmed pay equity in 96% of the cases.Mayo Clinic's structured, salary-only compensation model appears to have successfully...

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What to Expect in 2020: An Even Greater Focus on Social Determinants of Health

The question now is whether emerging reimbursement models will shift things into high gear or maintain the unhurried status quo.At the dawn of a new year in which healthcare is sure to be among the...

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Medicare Shared Savings ACOs Generated $1.7B in Savings in 2018

Of the 548 ACOs that cared for 10.1 million beneficiaries, 66% saved money and 37% saved enough money to earn bonuses.The Medicare Shared Savings Program generated $1.7 billion in total savings in...

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The Reality of Success in Medicare Advantage

Every provider organization must be able to define what success looks like in Medicare Advantage. Effective models include four foundational principles – strategic contracts, accurate coding and...

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HHS Delivers Long-Awaited Stark Law Regulatory Overhaul

The two proposed rules from HHS OIG and CMS aim to make it easier to provide value-based care without running afoul of self-referral and anti-kickback laws.With a pair of proposed regulations, the U.S....

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