Serving the Value-Based Care Community
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RevCycleIntelligence | June 9, 2023
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CMS will test a new primary care model in eight states with the hopes of improving patient care and increasing value-based opportunities for primary care organizations. The Making Care Primary (MCP) model aims to enhance care management and care coordination, provide primary care physicians with tools to form partnerships with healthcare specialists, and utilize community-based resources to address patient health needs and social determinants of health. Additionally, the model seeks to provide patients with integrated, person-centered, accountable primary care and improve care quality while reducing spending.
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How bright is your star shining? If you’re looking to improve your Star Rating with the Centers for Medicare & Medicaid Services, you’ve come to the right place. Your Star Rating isn’t just a once-a-year focus, it’s a year-round effort. We asked our team of experts for their tips to improve your ratings. Here’s what they said.
1. Focus on weighted measures.
To ensure continuous performance improvement, Star Rating measures, weights, and methodology change annually to reflect CMS’ priorities and address parity across measures and plans. “Weighted measures are those selected by CMS to evaluate health plan performance, and they play a critical role in the health plan’s ability to earn a 4-plus Star Rating,” says Sarah Fitzharris, a value-based care manager at DataLink. So, what can payers do to engage provider groups?
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Paralleling many conversations across the current socio-political landscape, life sciences have been striving to fix the lack of diversity in clinical trials. This has taken a few different angles ranging from access to representative results. While these conversations have been ongoing, two recent updates prompted more urgent action: Medicaid became responsible for the costs of clinical trials for Medicaid patients,1 and the FDA issued guidance requiring clinical trial diversity plans. Using real world evidence in the design of a clinical trial allows life science organizations to ensure they meet diversity requirements in advance of beginning the trial, thus reducing the need for subsequent iterations and using resources most efficiently.
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Health Affairs | June 8, 2023
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Improving health equity in the US will require redesigning value-based payment using a set of coordinated strategies to promote equity alongside clinical, quality, and cost-efficiency outcomes. In part 1 of this article, we articulated the rationale and need for these equity-aligned design changes, and we laid out tools for tackling three design considerations in value-based payment: organizational participation, payment rules, and risk adjustment. In part 2 below, we extend that work—and ongoing efforts in the Payment Insights Team and the Value & Systems Science Lab to analyze payment model design—by describing a set of tools and related examples corresponding to four additional design considerations...
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UPCOMING WEBINARS:
Ongoing OIG Risk Adjustment Scrutiny: Top 3 Key Insights for ACOs, Payers, CINs and Providers
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Topic: Understanding OIG Risk Adjustments audits, learning to identify potential audit threats, and developing solutions to mitigate risk, elevate member quality-of-care, and improve outcomes
June 22, 2023 | 2 PM EST
Succeeding in Traditional MIPS (While You Still Can)
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Topic: Developing and deploying a traditional MIPS strategy that earns incentives (and avoids penalties) now, and leads to future success
June 27, 2023 | 1 PM EST
MIPS Value Pathways (MVPs): How to Succeed in Post-Traditional MIPS
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Topic: Creating and implementing an MVP strategy now that will provide an advantage in the future
July 11, 2023 | 1 PM EST
Healthjump Client Product Review: Harnessing EHR Data to Save Time for Practices
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Topic: How Healthjump's innovative EHR platform has revolutionized practices with seamless integration, workflow efficiency, and financial advantages
July 13, 2023 | 1 PM EST
RECORDED WEBINARS:
Maximizing financial performance under value-based care: A spotlight on contracting and risk adjustment
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Topic: Incorporating data-infused goals in contract design, gaining enhanced visibility through real-time performance measurement, and shifting risk adjustment upstream
The Mystique of eCQMs: What Are Advantages for ACOs' APP Reporting?
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Topic: Understanding eCQMs, how they may help or hinder ACOs, and how to get more out of data to improve outcomes and costs
The Path to Health Equity: Closing the gap between policy and SDOH actionability
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Topic: Problems and opportunities of SDOH, the gap between CMS policy and available tools, costs and incentives by model, and unique approaches and solutions
Check our our Webinar Archive to view past webinars on a variety of value-based care related topics!
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2023 Virtual National Advanced Healthcare at Home Summit
July 11-14, 2023 | Virtual
RISE West 2023
August 28-30, 2023 | Dallas, TX
Activate2023
September 27-28, 2023 | Minneapolis, MN
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EXHIBITOR SPOTLIGHT
Flash Interview
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Our thoughts and prayers are with the people of Ukraine.
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