In the ongoing transition to value-based care (VBC), provider contracting poses challenges for health plans and providers. In my past role as the VP of Quality at a large health plan, I was part of the team that reviewed provider contracts that included risk around quality. Adding my role to the review process reduced the frustration of the Network and Quality teams because I could identify the reporting requirements that the health plan couldn't meet and create alignment with measure
Read More
Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant
Medical Home Network Expands Value-Based Care Reach with 64 FQHCs in New ACOs
What You Should Know:
- Medical Home Network (MHN), a leader in transforming care in the safety net, announced today its partnership with 64 federally qualified health centers (FQHCs) across seven states. These FQHCs will participate in two key CMS value-based care programs: ACO REACH and MSSP (Medicare Shared Savings Program).
- This expansion comes on the heels of an impressive achievement by existing MHN partners: $10.1M in gross savings and a perfect quality score in the 2022
Read More
Elevating Healthcare Through Risk Stratification: Lessons from North Carolina’s Value-Based Initiatives
As the healthcare landscape continues to evolve, there's a clear trend towards value-based care (VBC). This significant shift, which places a premium on patient health outcomes, diverges from the traditional fee-for-service approach. The aftermath of the COVID-19 pandemic has mainly catalyzed the adoption of VBC models, highlighting the importance of care quality and effectiveness rather than the sheer volume of services. This change reshapes healthcare, aligning it more closely with patient
Read More
Ohio State & CVS Form ACO to Elevate Medicare Care in Central Ohio
What You Should Know:
The Ohio State University Wexner Medical Center and CVS Accountable Care, part of CVS Health® (NYSE: CVS), today announced the creation of an accountable care organization (ACO) to improve the quality of care for Medicare beneficiaries by Ohio State providers in central Ohio.This coordinated approach to delivering care is centered around each patient’s unique needs and emphasizes preventive wellness and proactive treatment of chronic conditions.
CVS ACO and
Read More
FQHCs Shine in Value-Based Care: MHN Partners Achieve $10M Savings and Perfect Quality Score
What You Should Know:
- Medical Home Network (MHN), a leading care enablement partner for FQHCs, announced that its partners participating in the NeueHealth Premier ACO achieved $10.1 million in gross savings and a perfect 100% quality score in the 2022 performance year.
- This accomplishment, under the ACO Realizing Equity, Access, and Community Health (REACH) Model, involved 20 FQHCs across Ohio, Missouri, and Illinois serving approximately 10,000 Medicare beneficiaries. The success
Read More
Patients Crave Conversational Texting, Frustrated by Simplistic Healthcare Communication
What You Should Know:
- A new survey by Artera, a leader in patient communication technology, reveals a stark disconnect between how healthcare providers communicate and what patients actually want.
- The findings, based on responses from over 2,000 patients, paint a picture of frustration and missed opportunities, with simple phone calls and one-dimensional text messages falling short of patient expectations.
Communication Breakdown
- Nearly half (45%) of patients have missed or
Read More
What Patients Want: Zocdoc’s Report Reveals Patient Preferences
What You Should Know:
- Zocdoc, the healthcare marketplace, has released its inaugural What Patients Want Report, offering valuable insights into what patients seek from their healthcare experience and providers.
- Based on millions of bookings and patient interactions, the report paints a picture of how patients are navigating the healthcare landscape today, and what they expect from their providers and the industry at large.
Key findings of the report include:
Women driving
Read More
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
Read More
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
Read More
Mobile Pay Revolutionizes Specialty Groups: Unlock the Data-Driven Potential
It’s no surprise that healthcare is doubling down on software investments for healthcare revenue cycle, including software with an AI component, like predictive analytics. What’s unique is that right-now value from AI in revenue cycle is happening outside the walls of a healthcare facility or medical practice. In fact, it’s originating from the device patients use most: their smartphone.
For specialty groups in particular, the ability to successfully engage patients in their financial
Read More
