Serving the Value-Based Care Community |
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Healthcare Dive | August 15, 2023
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ACO REACH, which began its first model year in January, is a redesign of CMS’ controversial direct contracting model that’s meant to tie traditional payments in Medicare to value and improve care coordination. Regulators shelved the direct contracting program last year, after some progressives slammed the model as a thinly veiled effort to privatize the Medicare fee-for-service program. The model, in which physicians can accept either full or partial capitation as payment, offers higher levels of risk and reward compared to other ACO models, while providing additional flexibilities. Along with the new name, ACO REACH has a stronger focus on health equity and provider governance than its direct contracting predecessor. The CMS on Monday unveiled new changes that were applauded by stakeholders, including the National Association of ACOs, which said that regulators addressed many concerns raised by its members. “We believe these changes will satisfy many concerns and stabilize future participation,” NAACOs CEO Clif Gaus said in a statement.
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If CMS’s new proposed option for APP Reporting becomes part of the Final Rule, ACOs will have the ability to limit quality reporting to Medicare patients only. Your ACO must now determine whether reporting Medicare-only patients saves work and money and best demonstrates your quality. Use these Roji TIPS to decide what approach will work for you. ACOs have resisted APP Reporting to avoid data aggregation from different physician EHRs. ACOs also want to limit their work to the core of Medicare patients included in the ACO. The following considerations are key to your decision about your APP Reporting approach… |
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Physicians Practice | August 16, 2023
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With the current administration of President Joe Biden, the U.S. Centers for Medicare & Medicaid Services (CMS) continue to make health equity a key aspect of value-based care. Studies are increasingly detailing how the conditions in which people are born, grow, live, work, and age – what are known as the social determinants of health (SDOH) – have an enormous impact on health outcomes, which we saw play out in COVID-19 cases. In particular, research documents that SDOH inequities are not only directly related to, but are one of the main causes of disparities in health outcomes. As a result, health providers are increasingly looking at SDOH as comorbidities and are exploring ways to practically integrate SDOH into their care models and recommendations in an attempt to measurably improve patient outcomes. However, according to The Physicians Foundation’s 2022 Survey of America’s Physicians, six out of 10 physicians said they do not have the time needed during appointments to adequately address SDOH with patients.
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MedCity News | August 11, 2023
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The goal of value-based care (VBC) is to create financial incentives for providers to improve patient outcomes while controlling costs of care. Unlike the traditional “fee for service” (FFS) model, under which providers are reimbursed based on volume, VBC rewards providers for efficiently delivering higher-quality care. While greater operational efficiency and cost control are essential to the success of VBC initiatives, so too is patient engagement. Care coordination and care management are far more difficult – and far less likely to achieve optimal outcomes – without patients who are fully engaged with their providers. |
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UPCOMING WEBINARS:
Harnessing predictive analytics to improve the impact of care delivery
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Topic: How risk-bearing entities can use predictive analytics to evaluate past performance, divide shared savings, assess and stay on top of provider impact, and make action-based recommendations
August 31, 2023 | 1 PM EST
HCC V28 Is Coming! Learn How to Strengthen Your Risk Adjustment Efforts
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Topic: Transformations happening in the medical record and risk adjustment spaces, preparing to maximize revenue through coding, and a case study with Physician Care Centers
September 7, 2023 | 1 PM EST
Unnecessary & Avoidable: Solutions for Emergency Department Diversion
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Topic: Understanding emergency department overutilizatio and how to avoid it using a consumer-centric approach
September 7, 2023 | 1 PM EST
Don’t Let Downside Risk Get You Down:
A discussion on effectively right-sizing your risk exposure, Part 1
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Topic: Understanding the world of risk and how to address it, including types of risk-taking organizations and risk-sharing contracts, current trends, provider risk concerns and solutions, and available carve-outs and coverage options
September 13, 2023 | 1 PM EST
The Future of Medicaid Reimbursement: What Do Proposed Regulations Mean For Provider & Health Plan Reimbursement?
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Topic: Understanding and preparing for upcoming changes to Medicaid reimbursement
September 14, 2023 | 2 PM EST
RECORDED WEBINARS:
The Explosion of Value Based Care: How Technology Can Help Us Scale
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Topic: How technology can accommodate and accelerate the rapid growth of Value Based Care Organizations
CASE STUDY: How Privia NT and VillageMD Reduced Referral Leakage, Specialty, & Admin Costs
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Topic: leveraging referral automation and data within your EHR to reduce leakage, Specialty & Admin costs
Migrating to HCC V28: 5 Keys to Success
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Topic: Identifying and discussing changes to risk scoring under HCC V28 & how to ensure success
Check our our Webinar Archive to view past webinars on a variety of value-based care related topics!
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RISE West 2023
August 28-30, 2023 | Dallas, TX
Activate2023
September 27-28, 2023 | Minneapolis, MN
23rd Population Health Colloquium
September 18-20, 2023 | Philadelphia, PA
APG Annual Fall Conference 2023
October 30 - November 1, 2023 | Washington, DC
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Propeller Health is a precision digital health company on a mission to uplift every person living with chronic disease so they can take control of their health. We power motivating, care-connected patient journeys and unify value for all stakeholders. In more than 150 peer-reviewed abstracts and publications, our FDA-cleared digital therapeutic platform – which includes inhaler sensors, a digital patient experience, a clinician insights portal for remote monitoring, and tailored patient support – demonstrates improved quality of life and clinical outcomes.
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Platinum Level Exhibitors
Thank you to our Platinum Level exhibitors. These organizations offer the absolute highest quality products & services to the ACO & IPA community. To learn more & visit their interactive booths, click on the logos below:
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Gold Level Exhibitors
Thank you to our Gold Level exhibitors. To learn more & visit their interactive booths, click on the logos below:
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Our thoughts and prayers are with the people of Ukraine. |
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