Shared Savings Program

QPP Proposed Rule for 2021: Update & Analysis | 8/28/2020

… the individual eligible clinician, group (TIN), or APM Entity, and only available to MIPS APM participants. While APP participation is optional for MIPS APM participants, it is mandatory for ACOs participating in the Medicare Shared Savings Program to report quality performance via the APP (although MIPS eligible clinicians in these ACOs would still have the option of reporting outside the APP). Composed of a fixed set of measures for each …

Slow Walking to Value Based Care: Why Fee for Service Still Rules | 8/26/2020

… 2017, according to Burwell, and hoped to reach the 50% mark by 2018. In March 2016, HHS said it had reached the 30% goal a year ahead of schedule, mainly because of the Medicare Shared Savings Program (MSSP). More recent data on the value-based-care movement comes from the Health Care Payment & Learning Action Network (LAN), a public-private partnership launched in 2015 by the Department of Health and …

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Medicare Shared Savings Program and readmission rate among patients with ischemic stroke | 8/24/2020

Medicare Shared Savings Program and readmission rate among patients with ischemic stroke Yeunkyung Kim , Laurent G. Glance , Robert G. Holloway , Yue Li Neurology Aug 2020, 95 (8) e1071-e1079; DOI: 10.1212/WNL. 10080 Citation Manager Formats This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased …

The math of ACOs | 8/20/2020

… Of the roughly 33 million lives covered by an ACO in 2018, more than 50 percent were commercially insured and approximately 10 percent were Medicaid lives. 2 On the whole, ACOs in the Medicare Shared Savings Program (MSSP) have delivered high-quality care, with an average composite score of 93.4 percent for quality metrics. However, cost savings achieved by the program have been limited: ACOs that entered MSSP during the …

Factors Associated with Reduced Medicare Spending in the Accountable Care Organization (ACO) Investment Model | 8/20/2020

… United States; 6 Centers for Medicare & Medicaid Services, Baltimore, MD, United States Research Objective The ACO Investment Model (AIM) was designed to encourage providers in rural or underserved areas to participate in the Medicare Shared Savings Program (SSP) by providing up‐front financial support for care transformation. In the second performance year, there were 41 ACOs that continued participation in AIM, with 423 434 beneficiaries assigned them. Our research objective …

Building a Successful ACO Risk Adjustment Program | 8/15/2020

Webinars 8.14.20 Building a Successful ACO Risk Adjustment Program To protect their annual benchmark performance and thrive in the Medicare Shared Savings Program (MSSP), ACOs must develop in-house risk adjustment expertise. In this webinar, we’ll explore what data, programs, and resources providers need to effectively document and code chronic conditions for Medicare members in capitated payment models. What You’ll Learn What data & analytics are needed for risk adjustment Effective …

[FR] All Documents | 8/15/2020

… Distribution of Critical Healthcare Resources… Centers for Medicare & Medicaid Services Proposed Rule Medicare Program: CY 2021 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; etc. FR Document: 2020-17127 Citation: 85 FR 50074 PDF Pages 50074-50665 (592 pages) Permalink Abstract: This major proposed rule addresses: Changes to the physician fee schedule (PFS); other changes to Medicare Part …

Direct Contracting Payment Models to Allow Concurrent Hospice Care | 8/14/2020

… and health care providers reduce the cost of care and improve quality within Medicare fee-for-service programs. The models adapt and integrate concepts from other programs such as Accountable Care Organizations, the Medicare Shared Savings Program , and Medicare Advantage, as well as strategies used in the private sector. Advertisement “One of the areas in which we see tremendous benefit is in this concurrent care for beneficiaries that elect Medicare …

CMS unveils new payment model for rural hospitals: 10 things to know | Becker’s Hospital Review | 8/12/2020

… an advisory council, and ensuring compliance with model requirements, CMS said. ACO transformation track 6. CMS will select up to 20 rural-focused ACOs to receive advance payments as part of joining the Medicare Shared Savings Program . The goal is to help CHART ACOs improve outcomes and quality of care for Medicare beneficiaries through value-based payment models. 7. A CHART ACO will be able to receive a one-time …

One Tech Firm’s Quest To Save Independent Physicians – And Our Healthcare System | Forbes | 8/12/2020

… the last year intentionally — and ultimately, quite serendipitously — putting the right frameworks in place to be able to quickly adapt in a shifting environment. An essential element of their plan was entering into a shared savings program by joining a physician-led Accountable Care Organization (ACO); another was finding a strategic partner to help guide them through the process and provide a playbook for success. “We realized the need to …

CMS announces a new value-based payment model for rural healthcare providers | Healthcare Finance | 8/12/2020

… of the ACO Investment Model (AIM), which saved $382 million over three years, CMS said. Providers participating in the ACO Transformation Track will enter into two-sided risk arrangements as part of the Medicare Shared Savings Program , and may use all waivers that are available in the MSSP program. CMS anticipates releasing a request for applications in the spring of 2021 and selecting up to 20 rural ACOs to participate …

News in brief | 8/11/2020

… Health Network, designed to deliver medical services to businesses, employees and their dependents. The Arkansas Health Network describes itself as a physician-driven, clinically integrated network that says it uses “new payment models involving shared savings program s, bundled payments and other initiatives focused on quality and value.” The network has more than 2,200 providers, 16 hospitals and 26 skilled nursing facilities. Little Rock Mayor Frank Scott Jr. and Bryan Day …

CMS unveils new alternative payment model for rural health | Modern Healthcare | 8/11/2020

… track effectively reboots the ACO investment model, which saved $382 million over three years, the agency said in a statement. It allows providers to take part in two-sided risk arrangements under the Medicare Shared Savings Program . According to the agency, participating ACOs will get a one-time upfront payment of at least $200,000 per beneficiary and monthly prospective payments for each beneficiary for up to two years. “The ACO …

CMS launches new alternative payment model for rural healthcare providers | FierceHealthcare | 8/11/2020

… on CMS’ ACO Investment Model (AIM), which has saved $382 million over three years, the agency said. Providers participating in this track will enter into two-sided risk arrangements as part of the Medicare Shared Savings Program (MSSP) and may use all waivers available in the MSSP program. CMS will release a Request for Applications in the Spring 2021 and plans to select up to 20 rural ACOs to participate …

New CMS value-based payment model aimed at rural hospitals, ACOs | Healthcare Dive | 8/11/2020

… as if classified as a hospital. In the other track, CMS will select 20 ACOs to participate starting in January 2022 for five years. They will also be required to participated in the Medicare Shared Savings Program . They will receive a one-time upfront payment of at least $200,000 plus $36 per beneficiary and be able to receive a prospective per member per month payment of at least $8 for …

How to Pandemic-Proof Our Healthcare Payment System | 8/10/2020

… these providers were able to rely on existing capabilities to meet patient needs. Their revenue streams remained consistent, unlike providers in FFS or even APMs built on the FFS chassis such as the Medicare Shared Savings Program . If all payments to healthcare providers were in global budgets or capitation, the response to the first wave of COVID-19 would have differed immensely. A consistent budget for an aligned population would …

Alston & Bird Health Care Week in Review - August 2020 #1 | 8/10/2020

… to the OPD Prior Authorization Process. On August 4, 2020, CMS issued a proposed rule entitled, CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled …

Medicare ACOs raise concerns about proposed quality reporting changes | Modern Healthcare | 8/7/2020

Print Getty Images CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3, CMS proposed three main changes related to quality: a new mechanism for ACOs to report quality measures, a reduction in the Medicare Shared Savings Program ‘s required measures and higher quality performance standards for ACO bonuses …

15 Covid-19 forecasts healthcare leaders must get right - MedCity News | 8/7/2020

… Value-Based Care contracts termed Alternative Payment Models (APMs) that includes downside financial risk if performance benchmarks are not achieved. When the pandemic hit, Medicare had to delay the transition from exiting APM (Medicare Shared Savings Program , NextGen ACO) to the next generation of these APMs such as Primary Cares First and Direct Contracting. In January 2020, there were 558 Medicare ACOs with many either scheduled to expire this year …

News: Public Inspection: CMS: Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug under a Prescription Drug Plan or an MA-PD plan; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; and Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy | 8/5/2020

Medicare Program: CY 2021 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; etc. An unpublished Proposed Rule by the Centers for Medicare & Medicaid Services on 08/17/2020 Enhanced Content - Sharing …

[FR] All Public Inspection Documents | 8/4/2020

… am Scheduled Pub. Date: 08/12/2020 FR Document: 2020-17086 PDF 785 Pages (1.94 MB) Permalink CY 2021 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; etc. Filed on: 08/04/2020 at 8:45 am Scheduled Pub. Date: 08/17/2020 FR Document: 2020-17127 PDF 1353 Pages (3.15 MB) Permalink Matching Special Filings Matching Regular Filings Regular Filing updated at 8:45 AM …

CMS pitches physician payment rule for 2021: 6 things to know | Becker’s Hospital Review | 8/4/2020

… to clarify the times when prolonged office and outpatient evaluation and management visits can be reported. The department proposed revaluing eight code sets, including maternity services, therapy evaluation and transitional care services. 5. Medicare Shared Savings Program . CMS proposed changes to the Medicare Shared Savings Program quality performance standard and reporting requirements for the performance year beginning Jan. 1, 2021. The department is also seeking comment on an alternative scoring …

CMS proposes changes to docs’ Medicare payments for 2021, including payment cuts for some specialties | FierceHealthcare | 8/4/2020

… Nikesh Patel, executive director of APTQI in a statement. Physical therapists, psychologists and social workers complained about cuts to their Medicare reimbursements last year as well. CMS also is proposing changes to the Medicare Shared Savings Program quality performance standard and quality reporting requirements for performance years beginning on Jan. 1, 2021. These changes will align with Meaningful Measures, reduce reporting burden and focus on patient outcomes, the agency said …

CMS Proposes to Boost Office Visit Pay, Expand Telehealth Coverage | RevCycle Intelligence | 8/4/2020

… administration services; permanent policy clarifications for remote physiologic monitoring services; direction supervision via real-time, interactive audio and video technology; new add-on codes for opioid use disorder treatment; and updates for the Medicare Shared Savings Program 2020 performance year. To view the full rule, click here . Tagged …

Trump orders HHS to make telehealth expansion permanent | Modern Healthcare | 8/3/2020

… if state laws allow it. The agency is also “clarifying that pharmacists can provide services as part of the professional services of a practitioner who bills Medicare,” CMS said in a statement. The Medicare Shared Savings Program will also likely see changes for 2021, many of them owed to the COVID-19 pandemic. “For performance year 2020, we are proposing to provide automatic full credit for CAHPS patient experience of …

Community Health

CMS announces a new value-based payment model for rural healthcare providers | Healthcare Finance | 8/12/2020

… The Centers for Medicare and Medicaid Services today announced a new value-based payment model for rural healthcare providers. The Community Health Access and Rural Transformation (CHART) Model ties payment to value, increases choice and … into two-sided risk arrangements as part of the Medicare Shared Savings Program, and may use all waivers that are available in the MSSP program. CMS anticipates releasing a request for applications in the spring …

Centers for Medicare and Medicaid Services

CMS announces a new value-based payment model for rural healthcare providers | Healthcare Finance | 8/12/2020

… as expanding telehealth to allow the beneficiary’s place of residence to be an originating site. Susan Morse , Managing Editor The Centers for Medicare and Medicaid Services today announced a new value-based payment model for … into two-sided risk arrangements as part of the Medicare Shared Savings Program, and may use all waivers that are available in the MSSP program. CMS anticipates releasing a request for applications in the spring …

ACO

One Tech Firm’s Quest To Save Independent Physicians – And Our Healthcare System | Forbes | 8/12/2020

shared savings program by joining a physician-led Accountable Care Organization (ACO); another was finding a strategic partner to help guide them through the process and provide a playbook for success. “We realized the need to be nimble and change with the times,” said Scheitler, referring to the impetus of beginning work with Aledade last year. Founded in 2014 by Farzad Mostashari, MD, Aledade is a health IT company building …

COVID-19

One Tech Firm’s Quest To Save Independent Physicians – And Our Healthcare System | Forbes | 8/12/2020

… find ways to provide what their patients need with the limited resources they have, while managing the mounting challenges that Covid-19 has brought to bear. Others are considering selling to survive, as they struggle … An essential element of their plan was entering into a shared savings program by joining a physician-led Accountable Care Organization (ACO); another was finding a strategic partner to help guide them through the process …

Rural Health

CMS announces a new value-based payment model for rural healthcare providers | Healthcare Finance | 8/12/2020

… Susan Morse , Managing Editor The Centers for Medicare and Medicaid Services today announced a new value-based payment model for rural healthcare providers. The Community Health Access and Rural Transformation (CHART) Model ties payment to … into two-sided risk arrangements as part of the Medicare Shared Savings Program, and may use all waivers that are available in the MSSP program. CMS anticipates releasing a request for applications in the spring …

Department of Health and Human Services

CMS launches new alternative payment model for rural healthcare providers | FierceHealthcare | 8/11/2020

… an executive order issued by President Donald Trump issued last week to support healthcare in rural areas. Trump directed the Department of Health and Human Services (HHS) to set up a new voluntary pilot payment … into two-sided risk arrangements as part of the Medicare Shared Savings Program (MSSP) and may use all waivers available in the MSSP program. CMS will release a Request for Applications in the Spring 2021 …

CMS Innovation Center

CMS unveils new alternative payment model for rural health | Modern Healthcare | 8/11/2020

… community transformation track, up to 15 rural communities will receive as much as $2 million in initial funding from the CMS Innovation Center to reform care delivery and make capitated payments to providers. Each community … take part in two-sided risk arrangements under the Medicare Shared Savings Program. According to the agency, participating ACOs will get a one-time upfront payment of at least $200,000 per beneficiary and monthly prospective …

ACOs

Medicare ACOs raise concerns about proposed quality reporting changes | Modern Healthcare | 8/7/2020

Print Getty Images CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3, CMS proposed three main changes related to quality: a new mechanism for ACOs to report quality measures, a reduction in the Medicare Shared Savings Program’s required measures and higher quality performance standards for ACO bonuses …

CDC

15 Covid-19 forecasts healthcare leaders must get right - MedCity News | 8/7/2020

… results in millions of dollars of losses. On February 26, the novel coronavirus began infecting these budgeting forecasting models. The CDC announced the first community spread and fifteen known cases of Covid-19 in the … Medicare had to delay the transition from exiting APM (Medicare Shared Savings Program, NextGen ACO) to the next generation of these APMs such as Primary Cares First and Direct Contracting. In January 2020, there were …

American Medical Association

CMS proposes changes to docs’ Medicare payments for 2021, including payment cuts for some specialties | FierceHealthcare | 8/4/2020

… proposing to revise the times used for ratesetting for this code set,” the agency said in a fact sheet . The American Medical Association (AMA) issued a statement supporting the E/M modifications that implement significant … as well. CMS also is proposing changes to the Medicare Shared Savings Program quality performance standard and quality reporting requirements for performance years beginning on Jan. 1, 2021. These changes will align with Meaningful Measures …

Medicare

HHS spokesperson says agency will renew public health emergency | Modern Healthcare | 6/29/2020

Medicare inpatient 20% add-on payment for COVID-19 patients , increased federal Medicaid matching rates , requirements that insurers cover COVID-19 testing without cost-sharing, and waivers of telehealth restrictions . Adjustments CMS made to the Medicare Shared Savings Program for accountable care organizations are also connected to the length of the public health emergency. The number of months the emergency lasts affects the amount of shared losses an ACO must …

Medicaid

What does the pandemic mean for NY’s accountable care organizations | Crain’s New York Business | 6/23/2020

Medicaid Services introduced policy changes April 30 to add flexibility in its Medicare Shared Savings Program and Next Generation ACO program. “CMS has taken notable steps to address concerns about the effects of the pandemic,” said Allison Brennan, senior vice president of government affairs at the National Association of ACOs, in Washington, D.C. “We may not be able to pandemic-proof value-based payments, but CMS can still provide meaningful …

Medicare Payment Advisory Commission

ACOs Can Grow Value-Based Payment in Medicare, But Changes Needed | RevCycle Intelligence | 6/18/2020

… based payments in the federal healthcare program, the Commission reports. Source: With Medicare spending growing at an unsustainable rate, the Medicare Payment Advisory Commission is advising Congress to accelerate the transition to value-based payment … unclear, the Commission said. In fact, changes to the Medicare Shared Savings Program that encourage ACOs to bear more financial risk could reduce savings by dissuading providers from participating. READ MORE: Entering the Next Phase …

MedPAC

More than half of ACOs likely to leave Medicare Shared Savings program | Healthcare Finance | 4/14/2020

… new survey released by the National Association of Accountable Care Organizations. While 30% of accountable care organizations in the Medicare Shared Savings Program said it was not likely they would drop out, 21% said they … shared losses. On April 13, the Medicare Payment Advisory Commission MedPAC urged CMS Administrator Seema Verma not to use data from 2020 when evaluating ACOs, saying providers should be allowed to focus on COVID-19 …

ACA

CMMI nudges providers toward value, but progress is limited | Modern Healthcare | 3/14/2020

… according to a report from consulting firm Avalere Health. “I think (CMMI is) one of the bigger impacts of the ACA that’s rarely talked about,” said Dr. Patrick Conway, former CMMI director and former CEO … a new Innovation Center model or apply it to Medicare Shared Savings Program.” Emily Brower Senior vice president of clinical integration and physician services Trinity Health But many industry insiders say that expansion shouldn’t be …

Population Health

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

The health system used its new population health tools to better manage patient care, ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent, non-profit health systems in the Pittsburgh metropolitan market and surrounding communities: Butler Health System, Excela Health, St. Clair Hospital and …

Electronic Health Records

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … to overcome were that we were using nearly 20 different electronic health records vendors across our network. We wanted to be better together, find economies of scale and bring multiple data sources together to get …

Clinically Integrated Network

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … to providing high-quality healthcare come together to form a clinically integrated network to deliver on accountable care organization and other value-based contracts,” said Dr. Robert Zimmerman, chief medical officer at Bridges Health Partners …

Health Management

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … Health Intelligence, Epic, GSI Health, Health Catalyst, HealthEC, Innovaccer, MAP Health Management, Medicity, NextGen Healthcare, Optum, Orion Health, Varian Medical Systems and ZeOmega. MEETING THE CHALLENGE The concept of population health management is a process …

Population Health Analytics

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … populations.” Bridges Health Partners also was looking for a scalable population health analytics platform to be its single source of truth where everyone in the organization would be using the same data when making business …

Coordinated Care

CMS Accepting Applications for New Direct Contracting Models | RevCycle Intelligence | 11/27/2019

… opportunities for a wider range of provider organizations that were unable to participate in legacy models, such as the Medicare Shared Savings Program (MSSP) or the Next Generation Accountable Care Organization (ACO) Model. READ MORE … that patients have access to the high-quality, accountable, and coordinated care physician groups have been providing for decades,” Don Crane, president and CEO said in the statement. The statement goes on to mention that …

Chronic Disease Management

CMS Accepting Applications for New Direct Contracting Models | RevCycle Intelligence | 11/27/2019

Shared Savings Program (MSSP) or the Next Generation Accountable Care Organization (ACO) Model. READ MORE: HHS Launching Direct Contracting Payment Models for Primary Care CMS expects the new opportunity to attract the attention of physician practices and other organizations because Direct Contracting is anticipated to reduce burdens and support chronic disease management efforts already underway by these providers. An essential aspect of Direct Contracting is also to provide new opportunities …

Medicare Advantage

After Generating $1.7M, Genesis Looks to Expand In-House ACO Outside of Its Centers | 11/19/2019

… premium dollar as a way to navigate a tangled thicket of payers. And while most attention has been on the Medicare Advantage model, one major operator sees opportunity in an arrangement that many SNFs dread … for meeting the cost-cutting benchmarks set under the Medicare Shared Savings Program (MSSP) in 2018. Genesis recently renamed its ACO as “LTC ACO,” as part of a push to expand its current enrollment of …

Readmissions

Genesis HealthCare Reports Third Quarter 2019 Results | 11/9/2019

… relationships and consistent clinical outcomes and results. Currently, 76% of our facilities are located in Genesis’ historical eastern markets.” Medicare Shared Savings Program (MSSP) As the industry continues to migrate from fee-for-service to … helping them improve overall healthcare quality and reduce unnecessary hospital readmissions. GPS is the only captive SNFist company in the industry and the only post-acute sponsored accountable care organization in the United States. 2018 …

Hospital Readmissions

Genesis HealthCare Reports Third Quarter 2019 Results | 11/9/2019

… relationships and consistent clinical outcomes and results. Currently, 76% of our facilities are located in Genesis’ historical eastern markets.” Medicare Shared Savings Program (MSSP) As the industry continues to migrate from fee-for-service to … patients, helping them improve overall healthcare quality and reduce unnecessary hospital readmissions. GPS is the only captive SNFist company in the industry and the only post-acute sponsored accountable care organization in the United States …

Aledade

One Tech Firm’s Quest To Save Independent Physicians – And Our Healthcare System | Forbes | 8/12/2020

shared savings program by joining a physician-led Accountable Care Organization (ACO); another was finding a strategic partner to help guide them through the process and provide a playbook for success. “We realized the need to be nimble and change with the times,” said Scheitler, referring to the impetus of beginning work with Aledade last year. Founded in 2014 by Farzad Mostashari, MD, Aledade is a health IT company building …

Caravan Health

Medicare ACOs raise concerns about proposed quality reporting changes | Modern Healthcare | 8/7/2020

Print Getty Images CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3 … enough to (understand) preventive care.” While Tim Gronniger, CEO of Caravan Health, which operates 12 ACOs, isn’t too concerned about the reduction of measures, he is worried that poor performance on one measure could tank …

Privia Health

How will history judge our response to the pandemic? | Modern Healthcare | 4/18/2020

… Alabama ACOs may need additional leeway from the CMS The article “Medicare may lose majority of risk-bearing ACOs from shared savings program,” highlights the threat COVID-19 presents to the nations’ accountable care organizations … Mark Foulke Executive vice president of transformational value-based care Privia Health

Avalere Health

Rolling back regulatory relief will be tricky for HHS | Modern Healthcare | 4/3/2020

… to enforce those HIPAA requirements in order to serve the broader public health goals,” said Nick Diamond, a consultant with Avalere Health. Regulatory relief in the fight against COVID-19 Hospitals without walls: The CMS … Payment Program’s Merit-based Incentive Payment System and the Medicare Shared Savings Program for accountable care organizations. That can be difficult for providers because the federal government is essentially turning a blind eye to compliance …

Optum

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … Health Catalyst, HealthEC, Innovaccer, MAP Health Management, Medicity, NextGen Healthcare, Optum, Orion Health, Varian Medical Systems and ZeOmega. MEETING THE CHALLENGE The concept of population health management is a process. Populations need to be identified …

NextGen Healthcare

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … that emerged on top for this population health effort was NextGen Healthcare Population Health, formerly known as EagleDream Health. “We decided on several must-haves, including the ability to roll up quality metrics, deliver multiple …

HealthEC

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

… ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent … Cerner, Elekta, Enli Health Intelligence, Epic, GSI Health, Health Catalyst, HealthEC, Innovaccer, MAP Health Management, Medicity, NextGen Healthcare, Optum, Orion Health, Varian Medical Systems and ZeOmega. MEETING THE CHALLENGE The concept of population health management …

Universal Health Services

UHS ACOs Saved Medicare $65.2 million in 2018 | 11/22/2019

Prominence Health Plan, a subsidiary of Universal Health Services (UHS), announced the 2018 results of its seven UHS Accountable Care Organizations (ACOs) showing a continued trend of increased cost savings and improved quality. In 2018 … from volume-based payments to value-based payments. Within the shared savings program, providers can earn back part of the savings they generate for Medicare by hitting pre-determined spending goals. “The ACO concept is …

PatientPing

Care Collaboration Platform Helps its National Community of ACO Providers Generate Over $430 Million in Shared Savings | BioSpace | 10/31/2019

Care Collaboration Platform Helps its National Community of ACO Providers Generate Over $430 Million in Shared Savings Published: Oct 31, 2019 BOSTON , Oct. 31, 2019 /PRNewswire/ – PatientPing, the nation’s leading care collaboration platform, would like to congratulate its national network of Accountable Care Organizations (ACOs) for generating more than $430 million in shared savings in 2018 under the Medicare Shared Savings Program (MSSP). The care collaboration platform’s ACO network includes …

Leavitt Partners

Medicare ACO Results For 2018: Double The Downside Risk Adoption, Double The Savings, And All ACOs Types Are Achieving Savings | Health Affairs | 10/25/2019

… CMS) released the performance results for the sixth year (2018) of Medicare’s flagship Accountable Care Organization (ACO) program, the Medicare Shared Savings Program (MSSP). Over the last several years and from a variety of different … Authors’ analyses of public CMS MSSP performance data and propriety Leavitt Partners Torch Insight data Net Program Savings Increases For Second Year Exhibit 2 shows MSSP performance relative to benchmarks over the history of the …

Lightbeam Health Solutions

Lightbeam ACO Clients Continue to Outperform the Market, per 2018 MSSP ACO Performance Results | 10/15/2019

Blog This Lightbeam Health Solutions, the leader in end-to-end population health management solutions and services, announced that Accountable Care Organizations (ACOs) who have achieved a positive savings rate using Lightbeam technology generated more than $602 million in shared savings over the last five performance years in the Medicare Shared Savings Program (MSSP). In 2018 alone, Lightbeam’s ACO clients generated more than $130 million in gross shared savings while …

Navigant

Survey results show risk is in the eye of the beholder | Modern Healthcare | 7/13/2019

… that.” Edward-Elmhurst’s 85% includes all arrangements in which part of its payment was affected by performance, including the Medicare Shared Savings Program and contracts with its large commercial payers, said Shawn Roark, the system’s … in 2018, up from 59% in 2017. In a recent Navigant survey , 64% of health system finance leaders said they plan to assume risk in contracts with commercial payers in the next one to three …

Centene

Membership increases drive Anthem’s Q1 revenue growth above 9% | Healthcare Dive | 4/24/2019

… the conversation during a first quarter call with investors Wednesday and no analyst asked the insurance giant to weigh in. Centene CEO Michael Neidorff provided vague comments during his Q1 investor call Tuesday about the … expect 30% of value-based care will be tied to shared savings programs, up from 24% in 2018,” she said. Interest in the new PBM offering is continuing to build, she said, noting that attendance …

UnitedHealth Group

Former CMS Leader Andy Slavitt to Keynote Arcadia Aggregate Event | 4/22/2019

Shared Savings Program. Prior to CMS, Slavitt worked at UnitedHealth Group, eventually serving as the group executive vice president for Optum which he grew to a $40 billion health services enterprise. Featured Speakers include Healthcare Leaders from Across the Country In addition to Slavitt, Aggregate will feature sessions with national industry leaders. Arcadia customers will learn about best practices and strategies, engage with industry analysts and other thought leaders, explore …

Town Hall Ventures

Former CMS Leader Andy Slavitt to Keynote Arcadia Aggregate Event | 4/22/2019

Town Hall Ventures , a venture fund that invests in healthcare companies that serve vulnerable and underserved populations covered by Medicare and Medicaid. During Slavitts CMS tenure from 2015 to 2017, he led numerous population health management-related initiatives including driving the nations largest payer toward value-based care payment models, the implementation of the value-based-care-focused MACRA legislation, and the expansion of the Medicare Shared Savings Program. Prior …

Former CMS Leader Andy Slavitt to Keynote Arcadia Aggregate Event | Malvern Daily Record | 4/22/2019

Town Hall Ventures , a venture fund that invests in healthcare companies that serve vulnerable and underserved populations covered by Medicare and Medicaid. During Slavitt’s CMS tenure from 2015 to 2017, he led numerous population health management-related initiatives including driving the nation’s largest payer toward value-based care payment models, the implementation of the value-based-care-focused MACRA legislation, and the expansion of the Medicare Shared Savings Program. Prior …

Merrill Lynch

ApolloMed And Network Medical Management Announce Completion Of Merger And Listing On The Nasdaq Capital Market | PR Newswire | 12/11/2017

… This merger, along with our listing on NASDAQ, are important milestones as we continue to build shareholder value.” Advisors BofA Merrill Lynch acted as exclusive financial advisor to ApolloMed. McDermott Will & Emery served as legal … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

ApolloMed And Network Medical Management Announce Completion Of Merger And Listing On The Nasdaq | PR Newswire | 12/11/2017

… This merger, along with our listing on NASDAQ, are important milestones as we continue to build shareholder value.” Advisors BofA Merrill Lynch acted as exclusive financial advisor to ApolloMed. McDermott Will & Emery served as legal … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Genesis Healthcare

GENESIS HEALTHCARE REPORTS SOLID FOURTH QUARTER AND YEAR END 2019 RESULTS NYSE:GEN | 3/16/2020

KENNETT SQUARE, Pa., Genesis Healthcare, Inc. (Genesis, or the Company) (NYSE: GEN ), one of the largest post-acute care providers in the United States, today announced operating results for the fourth quarter and year ended … net income through our LTC ACO’s participation in the Medicare Shared Savings Program.” “We look forward to building on these accomplishments in 2020,” continued Hager. “We remain optimistic that occupancy trends, our unique investment strategies …

Excela Health

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

The health system used its new population health tools to better manage patient care, ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent, non-profit health systems in the Pittsburgh metropolitan market and surrounding communities: Butler Health System, Excela Health, St. Clair Hospital and …

Washington Health System

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent, non-profit health systems in the Pittsburgh metropolitan market and surrounding communities: Butler Health System, Excela Health, St. Clair Hospital and Washington Health System. THE PROBLEM The organization was interested in assimilating employed and affiliated independent ambulatory provider groups focusing on quality and outcome improvement throughout the integrated, regional care network. “We had four health …

Butler Health System

With pop health analytics, Bridges Health Partners MSSP ACO saves $8 million in first year | Healthcare IT News | 12/2/2019

The health system used its new population health tools to better manage patient care, ER use, pre-visit planning and value-based care. December 02, 2019 12:34 PM Bridges Health Partners is a Medicare Shared Savings Program accountable care organization. It was formed in 2017 and comprises four independent, non-profit health systems in the Pittsburgh metropolitan market and surrounding communities: Butler Health System, Excela Health, St. Clair Hospital and …

Franciscan Health

Franciscan ACO High-Quality Performance Results in $14.4 Million Savings | Globe Newswire | 11/7/2019

November 07, 2019 11:30 ET Source: Franciscan Health INDIANAPOLIS, Indiana, Nov. 07, 2019 (GLOBE NEWSWIRE) – Franciscan Accountable Care Organization (ACO) Inc . – a statewide care coordination initiative of Franciscan Health – has earned high marks for its performance in the Medicare Shared Savings Program (MSSP) , according to a Centers for Medicare & Medicaid Services (CMS) audit. As a participant in an ACO, Franciscan partners with physicians, hospitals and other advance practice providers to …

Baptist Health Care

Care Collaboration Platform Helps its National Community of ACO Providers Generate Over $430 Million in Shared Savings | BioSpace | 10/31/2019

Shared Savings Program (MSSP). The care collaboration platform’s ACO network includes thousands of providers that participate in the MSSP and other innovative value-based-care delivery models, including CMS’ Next Generation ACO Program , to improve care quality and organizational outcomes. “PatientPing has been a valuable tool in Baptist Health Care Partners’ efforts as a value-based care team to help foster great outcomes for our patients,” said Isaac J. Myers …

Harvard Medical School

‘Telehealth titans’ discuss cost-savings of virtual care, describe the hospital of the future | Healthcare IT News | 10/25/2019

… panel this past week at the HIMSS Connected Health Conference in Boston, Dr. John Halamka, international healthcare innovation professor at Harvard Medical School, and four other telehealth experts tried to arrive at a definition of … contracts are value-based purchasing, risk contract, some kind of shared savings program,” he explained. “So in fact if I can see a patient in their home, it’s actually to our advantage, because we really …

Spectrum Health

Michigan health groups reap increasing profits for Medicare, doctors, hospital systems | Crain’s Detroit Business | 10/15/2019

… 5,000 physicians across Michigan’s Lower Peninsula. Partners include Bronson Healthcare, Covenant HealthCare, Henry Ford Allegiance Health, Sparrow Health System and Spectrum Health Lakeland. Over the two years in the program, Federation ACO has saved Medicare … Some 66 percent of ACOs achieved savings in the Medicare Shared Savings Program, which was authorized by the Affordable Care Act of 2010. Medicare ACOs are groups of doctors, hospitals and other health care providers …

HonorHealth

Innovation Care Partners announces earned revenue in Medicare Shared Savings Program | Markets Insider | Business Insider | 10/10/2019

SCOTTSDALE, Ariz. Innovation Care Partners, an affiliate of HonorHealth, announces that for the fifth year in a row, Scottsdale Health Partners (SHP) Medicare Shared Savings Program (MSSP) has earned a shared savings payment from Medicare for its outstanding quality and efficiency in 2018. Other accomplishments include: Scottsdale Health Partners MSSP One of 6 Arizona based MSSPs that earned revenue for 2018. The first Arizona MSSP to earn revenue in 2014 …

Mercy Health

CommonSpirit Health a Leader in Improving Quality and Outcomes for Patients while Reducing Medicare Spending by $39 Million | PR Newswire | 10/9/2019

… commitment to providing the best in value-based care, the system’s 15 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) also scored above the national average on quality with an average … 97% on quality, and saved Medicare $3.2 million . In Iowa , Mercy Health Network reduced inpatient hospitalizations by 8%, scored 94% on quality, and saved Medicare $4.9 million . MHN Partners, also in Iowa , reduced inpatient hospitalizations …

CommonSpirit Health

CommonSpirit Health a Leader in Improving Quality and Outcomes for Patients while Reducing Medicare Spending by $39 Million | PR Newswire | 10/9/2019

CHICAGO CommonSpirit Health , a new nonprofit health system operating in 21 states, today announced it generated $39 million in savings to Medicare as well as $30 million in earned savings in 2018. As evidence of CommonSpirit’s commitment to providing the best in value-based care, the system’s 15 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) also scored above the national average on quality with an …

Mercy

CommonSpirit Health a Leader in Improving Quality and Outcomes for Patients while Reducing Medicare Spending by $39 Million | PR Newswire | 10/9/2019

… commitment to providing the best in value-based care, the system’s 15 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) also scored above the national average on quality with an average … 97% on quality, and saved Medicare $3.2 million . In Iowa , Mercy Health Network reduced inpatient hospitalizations by 8%, scored 94% on quality, and saved Medicare $4.9 million . MHN Partners, also in Iowa , reduced inpatient hospitalizations …

Dignity Health

CommonSpirit Health a Leader in Improving Quality and Outcomes for Patients while Reducing Medicare Spending by $39 Million | PR Newswire | 10/9/2019

… commitment to providing the best in value-based care, the system’s 15 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) also scored above the national average on quality with an average … February 2019 through the alignment of Catholic Health Initiatives and Dignity Health. CommonSpirit Health is committed to creating healthier communities, delivering exceptional patient care, and ensuring every person has access to quality health care. With …

Catholic Health Initiatives

CommonSpirit Health a Leader in Improving Quality and Outcomes for Patients while Reducing Medicare Spending by $39 Million | PR Newswire | 10/9/2019

… commitment to providing the best in value-based care, the system’s 15 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) also scored above the national average on quality with an average … It was created in February 2019 through the alignment of Catholic Health Initiatives and Dignity Health. CommonSpirit Health is committed to creating healthier communities, delivering exceptional patient care, and ensuring every person has access to …

Cleveland Clinic

The key to success in value-based care: Cleveland Clinic’s chief managed care officer weighs in | Becker’s Hospital Review | 10/8/2019

… challenges to ensure such models will help the organization reduce costs while improving the quality of patient care. That’s why Cleveland Clinic will host a Value-Based Innovation Summit Oct. 21-23, at the Global Center … and we have two accountable care organizations. In the Medicare Shared Savings Program — which is essentially a large value-based care arrangement — we have substantial upside and we have some downside. We knew going into …

Michigan Medicine

Michigan physicians save Medicare $43.1 million, while improving care for Michiganders | 10/8/2019

Michigan Medicine News A team of Michigan physician organizations improved care for more than 77,500 Medicare participants across the state, while making a positive difference in the cost of that care, according to new data … and high quality of care every year under the Medicare Shared Savings Program created under the Affordable Care Act. “We are proud to report savings yet again in 2018, which continues our strong track record …

Massachusetts General Hospital

ACOs to know | 2019 | Becker’s Hospital Review | 9/20/2019

… beneficiaries — participate in an ACO, and hundreds of other patients participate in commercial and Medicaid ACOs. CMS launched the Medicare Shared Savings Program in 2012, which includes three tracks, to encourage voluntary participation in ACO … a nonprofit system founded by Brigham and Women’s Hospital and Massachusetts General Hospital, both in Boston. Many of its hospitals are teaching affiliates of Boston-based Harvard Medical School. The health system has had ACO …

Methodist Health System

100 of the largest hospitals and health systems in America | 2019 | Becker’s Hospital Review | 9/12/2019

… provide care in North and South America. The faith-based health system has an ACO that participates in the Medicare Shared Savings Program. Avera Health (Sioux Falls, S.D.): 33 hospitals. Avera Health has more than … 1997, Texas Health Resources was formed through assets of Harris Methodist Health System in Fort Worth, Texas, and Presbyterian Healthcare Resources in Dallas. Since then, the health system has grown to include 29 hospitals and …

Kaiser Permanente

100 of the largest hospitals and health systems in America | 2019 | Becker’s Hospital Review | 9/12/2019

… UPMC Enterprises, that aims to support innovation and efforts to lower the cost of care with data-focused digital solutions. Kaiser Permanente (Oakland, Calif.): 39 hospitals. Kaiser Permanente is a 39-hospital system with 697 … health system has an ACO that participates in the Medicare Shared Savings Program. Avera Health (Sioux Falls, S.D.): 33 hospitals. Avera Health has more than 330 locations across 100 communities, covering a patient population of …

Texas Health Resources

100 of the largest hospitals and health systems in America | 2019 | Becker’s Hospital Review | 9/12/2019

… provide care in North and South America. The faith-based health system has an ACO that participates in the Medicare Shared Savings Program. Avera Health (Sioux Falls, S.D.): 33 hospitals. Avera Health has more than … challenges community hospitals face through consolidation in the healthcare space. Texas Health Resources (Arlington, Texas): 29 hospitals. In 1997, Texas Health Resources was formed through assets of Harris Methodist Health System in Fort Worth, Texas …

Trinity Health

100 of the largest hospitals and health systems in America | 2019 | Becker’s Hospital Review | 9/12/2019

… and now includes 105 hospitals in 18 states. The publicly traded health system has 17,000 licensed beds across all facilities. Trinity Health (Livonia, Mich.): 92 hospitals. Trinity Health is a Catholic health system with 92 … health system has an ACO that participates in the Medicare Shared Savings Program. Avera Health (Sioux Falls, S.D.): 33 hospitals. Avera Health has more than 330 locations across 100 communities, covering a patient population of …

Partners HealthCare

Partners HealthCare Transitions to Medicare Shared Savings Program (MSSP) | HIT Consultant | 8/23/2019

Recipient Email Enter a Message I read this article and found it very interesting, thought it might be something for you. The article is called Partners HealthCare Transitions to Medicare Shared Savings Program (MSSP) and is located at https://hitconsultant.net/2019/08/23/partners-healthcare-transitions-to-medicare-shared-savings-program-mssp/. Captcha Submit Partners HealthCare has transitioned to a Medicare Shared Savings Program (MSSP) through the Centers for Medicare and Medicaid …

Montefiore Health System

Survey results show risk is in the eye of the beholder | Modern Healthcare | 7/13/2019

… that.” Edward-Elmhurst’s 85% includes all arrangements in which part of its payment was affected by performance, including the Medicare Shared Savings Program and contracts with its large commercial payers, said Shawn Roark, the system’s … providers working together to share the risk,” he said. Photo Montefiore Health System in New York City said 40% of its net patient revenue was tied to risk-based contracts in 2018 and again in …

Baptist Health

Baptist Health Partners with PatientPing, Enabling | 5/14/2019

Baptist Health Partners with PatientPing, Enabling Real-Time Care Coordination Across Acute and Post-Acute Care Settings mayo 14, 2019 Baptist Health Partners with PatientPing, Enabling Real-Time Care Coordination Across Acute and Post-Acute … ACO located in Louisville, Kentucky , which participates in the Medicare Shared Savings Program (MSSP). The innovative partnership, which marks PatientPing’s entry into Kentucky and southern Indiana , will allow providers within Baptist Health’s network of hospitals …

Humana

Franciscan ACO High-Quality Performance Results in $14.4 Million Savings | Markets Insider | Business Insider | 11/7/2019

… ACO) Inc . – a statewide care coordination initiative of Franciscan Health – has earned high marks for its performance in the Medicare Shared Savings Program (MSSP) , according to a Centers for Medicare & Medicaid Services (CMS) audit. As … Franciscan ACO participates in similar programs with Anthem Medicare Advantage, Humana Medicare Advantage, and United Healthcare Medicare Advantage. Franciscan Health was among the first and few to enter the realm of ACO programs which was …

The speed of transformation: Preparing for the payment models of tomorrow | Modern Healthcare | 11/4/2019

… Shared Savings Program. 7 Commercial payers are fully engaged. UnitedHealthcare ® , the nation’s largest health insurer, currently covers more than 15 million patients through value-based plans, and by the end of 2020 expects to have $75 billion in reimbursements tied to such arrangements every year. 8 Other payers — Aetna, Cigna and Humana among them — are on a similar trajectory. 9 The Blue Cross Blue Shield plans say their value-based …

Aetna

The speed of transformation: Preparing for the payment models of tomorrow | Modern Healthcare | 11/4/2019

… Shared Savings Program. 7 Commercial payers are fully engaged. UnitedHealthcare ® , the nation’s largest health insurer, currently covers more than 15 million patients through value-based plans, and by the end of 2020 expects to have $75 billion in reimbursements tied to such arrangements every year. 8 Other payers — Aetna, Cigna and Humana among them — are on a similar trajectory. 9 The Blue Cross Blue Shield plans say their value-based …

Partners In Care ACO Generates Millions in Savings in the Medicare Shared Savings Program | PR Newswire | 10/24/2019

… Per Member Per Year (PMPY) in savings for Performance Year 2018 for the Centers for Medicare and Medicaid’s (CMS) Medicare Shared Savings Program (MSSP). By delivering 50% more savings than the minimum threshold required by … 15 PMPM savings in the pediatric population they manage for Aetna, as well as increased the Medicare STARS score in the first year of the Medicare Advantage program with United Healthcare from 3.15 to 3.94 …

WellCare Health

Collaborative Health Systems ACOs Deliver $53 Million in Total Savings to Medicare in 2018 | Markets Insider | Business Insider | 10/14/2019

TAMPA, Fla. , Oct. 14, 2019 /PRNewswire/ – WellCare Health Plans, Inc. (NYSE: WCG) and Collaborative Health Systems (CHS), a WellCare company, announced today that 13 CHS Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) – nearly 90% of all CHS ACOs – delivered $53.3 million in total savings to Medicare for performance year 2018, according to figures released by the Centers for Medicare & Medicaid Services. Earning Shared Savings and Meeting Quality Standards …

Collaborative Health Systems ACOs Deliver $53 Million in Total Savings to Medicare in 2018 | PR Newswire | 10/14/2019

TAMPA, Fla. , Oct. 14, WellCare Health Plans, Inc. (NYSE: WCG ) and Collaborative Health Systems (CHS), a WellCare company, announced today that 13 CHS Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) – nearly 90% of all CHS ACOs – delivered $53.3 million in total savings to Medicare for performance year 2018, according to figures released by the Centers for Medicare & Medicaid Services. Earning Shared Savings and Meeting Quality Standards (PRNewsfoto/WellCare …

Health Net

Allegheny Health Network’s Clinically Integrated Network Joins Medicare Shared Savings Program | PRWeb | 2/16/2018

Allegheny Health Network’s Clinically Integrated Network Joins Medicare Shared Savings Program Share Article AHN’s CIN, known as Physician Partners of Western PA, LLC, will now participate in the Medicare Shared Savings Program (MSSP) as an Accountable Care Organization (ACO). Dr. William Johnjulio Our clinically integrated network brings together independent and AHN-employed physicians in order to coordinate care across various medical specialties and care sites in a collaborative way. PITTSBURGH …

Advocate Health Network Goes Live with Caradigm Knowledge Hub and Caradigm Care Management | Business Wire | 12/14/2017

BELLEVUE, Wash.- Caradigm ® , the leader in enterprise population health, today announced that Advocate Health Network (AHN), the Accountable Care Organization (ACO) associated with St Joseph’s/Candler Health System, has implemented Caradigm Care Coordination solutions to support clinical decisions at the point-of-care. AHN is a participant in the Shared Savings Program by the Centers for Medicare & Medicaid Services. To better prepare for value-based care delivery and the needs …

Centene Corp

USMM Announces Participation in Successful CMS Shared Savings Program | PR Newswire | 11/1/2017

USMM Announces Participation in Successful CMS Shared Savings Program News provided by Nov 01, 2017, 09:09 TROY, Mich. , Nov. 1, 2017 /PRNewswire/ – The Centers for Medicare & Medicaid Services (CMS) released the 2016 performance year results … hospice, radiology, DME, and laboratory. USMM is a subsidiary of Centene Corporation (NYSE: CNC), with an integrated care delivery model across its Medicaid and dual-eligible membership. About Centene Corporation Centene Corporation, a Fortune 100 …

USMM Announces Participation in Successful CMS Shared Savings Program | PR Newswire | 11/1/2017

… Nov. 1, 2017 /PRNewswire/ – The Centers for Medicare & Medicaid Services (CMS) released the 2016 performance year results for the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). U.S. Medical Management (USMM) was a participating … hospice, radiology, DME, and laboratory. USMM is a subsidiary of Centene Corporation (NYSE: CNC), with an integrated care delivery model across its Medicaid and dual-eligible membership. About Centene Corporation Centene Corporation, a Fortune 100 …

Fidelis Care

USMM Announces Participation in Successful CMS Shared Savings Program | PR Newswire | 11/1/2017

USMM Announces Participation in Successful CMS Shared Savings Program News provided by Nov 01, 2017, 09:09 TROY, Mich. , Nov. 1, 2017 /PRNewswire/ – The Centers for Medicare & Medicaid Services (CMS) released the 2016 performance year results … expected benefits of the acquisition of Health Net, Inc. or Fidelis Care. These forward-looking statements can be identified by the fact that they do not relate only to historical or current facts. Without limiting …

USMM Announces Participation in Successful CMS Shared Savings Program | PR Newswire | 11/1/2017

… Nov. 1, 2017 /PRNewswire/ – The Centers for Medicare & Medicaid Services (CMS) released the 2016 performance year results for the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). U.S. Medical Management (USMM) was a participating … expected benefits of the acquisition of Health Net, Inc. or Fidelis Care. These forward-looking statements can be identified by the fact that they do not relate only to historical or current facts. Without limiting …

Farzad Mostashari

One Tech Firm’s Quest To Save Independent Physicians – And Our Healthcare System | Forbes | 8/12/2020

shared savings program by joining a physician-led Accountable Care Organization (ACO); another was finding a strategic partner to help guide them through the process and provide a playbook for success. “We realized the need to be nimble and change with the times,” said Scheitler, referring to the impetus of beginning work with Aledade last year. Founded in 2014 by Farzad Mostashari, MD, Aledade is a health IT company building …

Seema Verma

CMS unveils new alternative payment model for rural health | Modern Healthcare | 8/11/2020

… support. “The CHART Model represents our next opportunity to make investments that will transform the rural healthcare system,” CMS Administrator Seema Verma said in a statement. The new demonstration follows President Donald Trump’s executive order … take part in two-sided risk arrangements under the Medicare Shared Savings Program. According to the agency, participating ACOs will get a one-time upfront payment of at least $200,000 per beneficiary and monthly prospective …

Allison Brennan

Medicare ACOs raise concerns about proposed quality reporting changes | Modern Healthcare | 8/7/2020

Print Getty Images CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3 … do in terms of quality, it’s really too much,” said Allison Brennan, senior vice president of government affairs at the National Association of ACOs. The proposed changes to quality reporting and measures are part of …

Tim Gronniger

Medicare ACOs raise concerns about proposed quality reporting changes | Modern Healthcare | 8/7/2020

Print Getty Images CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3 … he’s not sure “it’s enough to (understand) preventive care.” While Tim Gronniger, CEO of Caravan Health, which operates 12 ACOs, isn’t too concerned about the reduction of measures, he is worried that poor performance on …

Alex Azar

HHS officially renews COVID-19 public health emergency | Modern Healthcare | 7/23/2020

Ron Sachs/picture-alliance/dpa/AP Images HHS Secretary Alex Azar HHS Secretary Alex Azar on Thursday officially extended the COVID-19 public health emergency designation for another 90 days. Significant funding and regulatory relief … length is also connected to CMS’ adjustments to the Medicare Shared Savings Program for accountable care organizations . The number of months the emergency lasts affects the amount of shared losses an ACO must pay back …

Andy Slavitt

CMMI nudges providers toward value, but progress is limited | 3/14/2020

… Medicaid Innovation) was ‘go figure out how fast people can change and try to go about 10% to 15% faster.’ ” Andy Slavitt Former CMS acting administrator and founder of United States of Care Congress created … a new Innovation Center model or apply it to Medicare Shared Savings Program.” Emily Brower Senior vice president of clinical integration and physician services Trinity Health But many industry insiders say that expansion shouldn’t be …

Tom Boggs

NextGen Healthcare Client Bridges Health Partners Achieves Medicare Shared Savings of $8 Million | Business & Finance | heraldchronicle.com | Business Wire | 10/30/2019

… Bridges Health Partners LLC in Pittsburgh achieved nearly $8 million in savings in its first performance year in the Medicare Shared Savings Program (MSSP) - representing a 3.4 percent reduction in spending - by leveraging NextGen® Population … fee-for-service world are faltering and not sustainable,” said Tom Boggs, President of Bridges Health Partners. “This is an opportunity to evolve and our results show that value-based care models do work. It …

Shawn Morris

Viewpoints: Lessons On Why It’s So Hard To Kick Sweets Like Candy Corn; Time To Double Efforts To Find A Cure For Alzheimer’s | Kaiser Health News | 10/30/2019

Shared Savings Program saved three-quarters of a billion dollars last year alone and no one notices, did the savings really matter? No prominent national business publication gave significant coverage to the late September announcement about the impressive savings from this value-based care program. (Shawn Morris, 10/30) The Hill: 4 Policies We Need To Protect Victims Of Domestic Violence Most women who are killed in the United States are …

Savas Petrides

Innovation Care Partners announces earned revenue in Medicare Shared Savings Program | Markets Insider | Business Insider | 10/10/2019

… Care Partners, an affiliate of HonorHealth, announces that for the fifth year in a row, Scottsdale Health Partners (SHP) Medicare Shared Savings Program (MSSP) has earned a shared savings payment from Medicare for its outstanding … physician leadership. This has served us well since 2012,” said Savas Petrides , MD, CEO, Innovation Care Partners. “Being physician led is the foundation for our success,” said James Whitfill MD, HonorHealth Chief Transformation Officer. “Allowing …

Laura Dyrda

ACOs to know | 2019 | Becker’s Hospital Review | 9/20/2019

… beneficiaries — participate in an ACO, and hundreds of other patients participate in commercial and Medicaid ACOs. CMS launched the Medicare Shared Savings Program in 2012, which includes three tracks, to encourage voluntary participation in ACO … accepted nominations for this list and conducted independent research. Contact Laura Dyrda at with any questions or comments on this list. Note: Organizations do not pay and cannot pay for inclusion on this list. The …

Jay Desai

Baptist Health Partners with PatientPing, Enabling | 5/14/2019

… the Baptist Health Accountable Care Organization (ACO), Baptist Health Care’s ACO located in Louisville, Kentucky , which participates in the Medicare Shared Savings Program (MSSP). The innovative partnership, which marks PatientPing’s entry into Kentucky and southern … and southern Indiana through our partnership with Baptist Health,» said Jay Desai , CEO of PatientPing. «We’re proud that innovative ACOs, such as Baptist Health, have chosen PatientPing to assist them with intelligent electronic notifications and …

Warren Hosseinion

ApolloMed Announces That Network Medical Management Has Entered Into An Agreement With Accountable Health Care IPA To Manage 160,000 Patients | PR Newswire | 1/8/2018

… to announce this new transaction with Accountable IPA, which will add 160,000 patients to our population health management platform,” stated Warren Hosseinion, M.D., Co-Chief Executive Officer of Apollo Medical Holdings. “Our integrated platform now … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Thomas Lam

ApolloMed Announces That Network Medical Management Has Entered Into An Agreement With Accountable Health Care IPA To Manage 160,000 Patients | PR Newswire | 1/8/2018

… capitation arrangements with multiple health plans.” “Accountable IPA shares our goal of supporting physicians in delivering exceptional patient care,” stated Thomas Lam , M.D., Co-Chief Executive Officer of Apollo Medical Holdings. “Our advanced analytics platform … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Kenneth Sim

ApolloMed Announces That Network Medical Management Has Entered Into An Agreement With Accountable Health Care IPA To Manage 160,000 Patients | PR Newswire | 1/8/2018

… are very excited to partner with Dr. Jayatilaka and his team to deliver differentiated care to Accountable IPA’s patients,” stated Kenneth Sim , M.D., Executive Chairman of Apollo Medical Holdings. “By bringing our distinctive MSO, clinical … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Albert Young

ApolloMed And Network Medical Management Announce Completion Of Merger And Listing On The Nasdaq Capital Market | PR Newswire | 12/11/2017

… Augusta as President, Mihir Shah as Chief Financial Officer, and Hing Ang as Chief Operating Officer. Adrian Vazquez , M.D. and Albert Young , M.D. will be Co-Chief Medical Officers. The Board of Directors will consist … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Gary Augusta

ApolloMed And Network Medical Management Announce Completion Of Merger And Listing On The Nasdaq Capital Market | PR Newswire | 12/11/2017

… led by Warren Hosseinion , M.D. and Thomas Lam , M.D. as Co-Chief Executive Officers, Kenneth Sim , M.D. as Executive Chairman, Gary Augusta as President, Mihir Shah as Chief Financial Officer, and Hing Ang as Chief … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Adrian Vazquez

ApolloMed And Network Medical Management Announce Completion Of Merger And Listing On The Nasdaq Capital Market | PR Newswire | 12/11/2017

… as Executive Chairman, Gary Augusta as President, Mihir Shah as Chief Financial Officer, and Hing Ang as Chief Operating Officer. Adrian Vazquez , M.D. and Albert Young , M.D. will be Co-Chief Medical Officers. The Board … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Mihir Shah

ApolloMed And Network Medical Management Announce Completion Of Merger And Listing On The Nasdaq Capital Market | PR Newswire | 12/11/2017

… M.D. and Thomas Lam , M.D. as Co-Chief Executive Officers, Kenneth Sim , M.D. as Executive Chairman, Gary Augusta as President, Mihir Shah as Chief Financial Officer, and Hing Ang as Chief Operating Officer. Adrian Vazquez … the CMS in connection with our participation in the Medicare Shared Savings Program (the “MSSP”); the success of the Company’s focus on next generation accountable care organization (“NGACO”), including whether the Company can continue to …

Michael Smith

USMM Announces Participation in Successful CMS Shared Savings Program | PR Newswire | 11/1/2017

USMM Announces Participation in Successful CMS Shared Savings Program News provided by Nov 01, 2017, 09:09 TROY, Mich. , Nov. 1, 2017 /PRNewswire/ – The Centers for Medicare & Medicaid Services (CMS) released the 2016 performance year results … care models and these results further validate that belief,” said Michael Smith , CEO of USMM. Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high …