Serving the Value-Based Care Community
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HealthcareExecIntelligence | September 26, 2022
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When MetNetOne Health Solutions established roaming physician teams that would go from practice to practice to help address chronic disease management needs around two decades ago, it became apparent that something was missing. The teams lacked a behavioral healthcare specialist. From that realization, the organization developed its strategy around integrated behavioral and physical healthcare, which MedNetOne Health Solutions continues to prioritize. Early on, the organization’s medical director invited behavioral healthcare specialists to join his practice and to practice in the same building. The organization watched no-show rates drop as a result.
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Philip M. Oravetz, MD, MPH, chief population health officer at Ochsner Health, in Louisiana, has some crucial advice for other health systems mulling value-based contracts. Before signing, get a commitment from your payers to provide claims data. This has been a sticking point for the move to value-based care for many years, said Dr. Oravetz, who provides physician leadership to Ochsner’s systems portfolio of value-based contracts. These include commercial shared savings and full-risk capitation within Medicare Advantage. Payers often have a critical view of what’s going on with patients compared with physicians and health care organizations, “because the claims data holds knowledge that is critical at the practice level,” he said. Dr. Oravetz discussed the path to success with Ochsner’s value-based initiatives...
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In February 2022, the Centers for Medicare & Medicaid Services (CMS) announced ACO REACH, extending the Direct Contracting model to better align with CMS’ strategic initiatives. In this new model, CMS introduced many significant changes to achieve the goals, after which REACH is named – Realizing Equity, Access, and Community Health. Specifically, CMS implemented five design elements to promote health equity and address healthcare disparities for underserved communities. This article will focus on the Health Equity Benchmark Adjustment (HEBA) policy among those five elements. The primary motivation for HEBA, as stated in the CMMI’s health equity webinar, is as follows: researchers have found that physicians in underserved communities are less likely to participate in ACO than others.
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Journal of AHIMA | September 26, 2022
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Health equity has been thrust into the spotlight with providers, regulatory agencies, and payers seeking ways to identify and eliminate disparities in care across race and ethnicity, gender, sexual orientation, socioeconomic status, and other lines. It is a priority further impacted by the emergence of new quality-based care models that go beyond those established under the Patient Protection and Affordable Care Act of 2010. For example, in January 2023, the Global and Professional Direct Contracting (GPDC) Model will be replaced with the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, a test program designed to address health inequities and improve support for provider-led organizations in risk-based arrangements.
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UPCOMING WEBINARS:
Cultivation of Physician Wellbeing in the Value Journey
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Topic: Addressing physician burnout and moral injury, its impact on the value-based care movement, and tools for transforming organizational culture
October 3, 2022 | 1 PM EST
3 Keys to Transitioning to an APM - Part 1: Build or Join? Determining your pathway
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Topic: Evaluating market strengths, competition, organization, and positioning to determine whether to build or join an ACO
October 4, 2022 | 1 PM EST
Harnessing Data in Value-based Care: How Atlantic Health Drives Success in Shared Savings Programs
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Topic: Using data and analytics to successfully streamline transitions of care
October 5, 2022 | 1 PM EST
Frictionless Healthcare: Fueling Behavior Change to Close Gaps and Improve Experience
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Topic: Understanding and utilizing behavioral science to improve patient experiences within healthcare organizations
October 6, 2022 | 1 PM EST
A Panel Discussion: Our Post-COVID Healthcare System & What We Have Learned
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Topic: Factors that contributed to the breakdown of healthcare systems, lessons learned from the COVID-19 crisis, and recommendations for creating a stronger healthcare system
October 13, 2022 | 2 PM EST
Hit your measures! Optimize reimbursements and achieve 15:1 ROI
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Topic: Utilizing new workflows and technology to improve patient outcomes, patient satisfaction, and shared savings
October 26, 2022 | 1 PM EST
MSSP to ACO REACH: TriHealth’s ACO Journey
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Topic: A large community health system's transition to Direct Contracting/ACO REACH, how the decision was made, and what has helped them succeed
November 1, 2022 | 12 PM EST
RECORDED WEBINARS:
The Teacher Becomes the Student: How to Successfully Implement Value-Based Care Strategies into Academic Medical Centers
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Topic: Making value-based care in academic medical centers possible and successful using best practices
Check our our Webinar Archive to view past webinars on a variety of value-based care related topics!
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Florida Association of ACOs (FLAACOs) Annual Conference
October 17 - 19, 2022 | Orlando, FL
Transitions 2022 | APG Colloquium
October 31 - November 2, 2022 | Washington, DC
22nd Population Health Colloquium
November 7 - 9, 2022 | Philadelphia, PA
HLTH 2022
November 13 - 16, 2022 | Las Vegas, NV
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Proficient Health improves care delivery and reduces costs by removing technology and communication barriers, and facilitating better communication and delivery/exchange of clinical information across a wide range of providers with disparate systems. Proficient Health's EHR companion supports better patient care, easier consults, improved operational efficiencies, enhanced in-network optimization and lowered costs for both healthcare providers and patients. With an abundance of experience and knowledge of the issues that healthcare organizations and providers face every day, the Proficient Health team understands the importance of collaboration in healthcare, and goes above and beyond to implement strategic solutions for their customers that are successful in meeting their business goals and delivering the best-possible care to their patients.
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Our thoughts and prayers are with the people of Ukraine
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