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ACO | Accountable Care Organization | Policy, News, Analysis, Insights - HIT Consultant

Clover Health Exits CMS ACO REACH Program to Focus on Medicare Advantage

by Fred Pennic 12/01/2023 Leave a Comment

Clover Health Exits CMS ACO REACH Program to Focus on Medicare Advantage

What You Should Know: - Clover Health, a physician enablement company committed to bringing access to great healthcare to everyone on Medicare announced that it has delivered notice to the Centers for Medicare and Medicaid Services (“CMS”) that it will exit the CMS ACO REACH Program at the end of the 2023 performance year. - Written notification will also be sent to all participating physicians in accordance with CMS requirements. - The decision will have no impact on its ACO REACH
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NextGen’s Value-Based Care Solutions Unlocks $82M in Medicare Savings

by Syed Hamza Sohail 11/21/2023 Leave a Comment

NextGen’s Value-Based Care Solutions Unlocks $82M in Medicare Savings

What You Should Know: NextGen Healthcare, Inc. a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year.The MSSP incentivizes hospitals, associations of physicians, and other healthcare facilities to form accountable care organizations (ACOs) that
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NorthShore – Edward-Elmhurst Health Signs Largest VBC Deal in 5 Years

by Fred Pennic 11/02/2023 Leave a Comment

NorthShore – Edward-Elmhurst Health Signs Largest VBC Deal in 5 Years

What You Should Know: - Edward-Elmhurst Health (NS-EEH) has announced a significant, long-term partnership with Lumeris, a pioneer in value-based care (VBC). This partnership is a major development in the healthcare industry, representing the largest VBC provider deal since 2018. - With rising expenses outpacing reimbursement rates, health systems and physician organizations are increasingly turning to value-based care to avoid layoffs and service cuts. NS-EEH, the third largest healthcare
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Chatbot Care Managers? Why ACOs Should Be Cautious in AI Adoption

by Theresa Hush, CEO and Co-founder of Roji Health Intelligence 09/27/2023 Leave a Comment

Chatbot Care Managers? Why ACOs Should be Cautious in AI Adoption

Given Artificial Intelligence’s potential to improve patient care and reduce costs, it’s no surprise that AI applications are gaining momentum in health care. As your organization explores the benefits of AI in your journey towards Value-Based Care, however, you need to carefully assess the implications, for better and worse. Evaluating AI implications can be tricky. Healthcare AI varies widely, with clinical technology paving the way for advancements in diagnostics and treatment. But
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Chatbot Care Managers? ACOs Should Be Cautious in AI Adoption

by Theresa Hush, CEO and Co-founder of Roji Health Intelligence 07/14/2023 Leave a Comment

Chatbot Care Managers? ACOs Should be Cautious in AI Adoption

Given Artificial Intelligence’s potential to improve patient care and reduce costs, it’s no surprise that AI applications are gaining momentum in health care. As your organization explores the benefits of AI in your journey towards Value-Based Care, however, you need to carefully assess the implications, for better and worse. Evaluating AI implications can be tricky. Healthcare AI varies widely, with clinical technology paving the way for advancements in diagnostics and treatment. But
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What VBC Providers Demand From Their IT Solutions

by Rohinee Lal, Principal Analyst at Signify Research 05/16/2023 Leave a Comment

Value-based care (VBC) is a healthcare delivery model that differs from traditional fee-for-service because rather than compensating providers based on the number of services provided, it ties the amount providers earn to the results they deliver for their patients.  The quality of these healthcare services is measured by patient outcomes that are based on metrics such as rate of hospital readmission, timeliness of care, and overall patient satisfaction.  This VBC model holds providers
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Aledade Expands Access to Value-Based Care for More Medicare Advantage Customers

by Fred Pennic 03/23/2023 Leave a Comment

Aledade ACO

What You Should Know: - Aledade is continuing its strong momentum today, announcing that Cigna Healthcare Medicare Advantage customers can now receive value-based care from Aledade’s network of independent primary care practices. - Participating practices can access Aledade’s cutting-edge data analytics, user-friendly guided workflows, and health care policy expertise, as well as integrated care services supported by AledadeCare Solutions. - This news comes shortly after Aledade
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Lumeris Launches Value-Based Care Accelerator for Practices

by Fred Pennic 11/03/2022 Leave a Comment

Lumeris Launches Value-Based Care Accelerator for Practices

What You Should Know: - Lumeris is launching Tribus, a value-based care accelerator for practices to convert from fee-for-service to value-based care using a community based-model. - Under the direction of Dr. Chuck Willey, CEO of Tribus, who is a practicing internal medical physician in St. Louis, doctors will participate in physician-to-physician training and mentorship for anyone looking for a better way to deliver at-risk care for senior populations. Why It Matters The Medicare
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Report: The State and Science of Value-Based Care

by Fred Pennic 09/16/2022 Leave a Comment

Report: The State and Science of Value-Based Care

What You Should Know: - Providers believe 96% of payment is now value-based in some capacity, and 58% believe their EHR vendor won’t be able to support the data strategies required to thrive under value-based care, according to a new study conducted by Morning Consult and Innovaccer. - The 37-page national research study uncovers key IT infrastructure issues healthcare leaders said are impeding or essential for progress towards accelerating their transformation to value-based
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6 Success Strategies as CMS Drives More Accountable Care by 2030

by Siddharth Thakkar, VP, Product and Marketing at IKS Health 07/13/2022 Leave a Comment

6 Success Strategies as CMS Drives More Accountable Care by 2030

For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Working to develop, test and evaluate new payment and delivery models in Medicare, Medicaid and the Children’s Health Insurance Program, CMMI has taken aim at improving the provider experience, generating better patient outcomes and reducing the overall cost of care. Recently, CMMI stated that by 2030 every Medicare
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