Hilary Hatch, Ph.D.’s Post

The recently released Health Care Transformation Task Force and National Association of ACOs resource on Reimagining Beneficiary Engagement in Accountable Care Models was featured in Medical Economics and Xtelligent Healthcare ! This resource outlines policy recommendations for the Centers for Medicare & Medicaid Services to strengthen patient engagement in ACO governance, care delivery redesign, and individual care planning, focusing on Medicare Accountable Care Organizations (ACOs).      “Effective patient engagement is paramount to the success of ACOs,” said Jeff Micklos, Task Force Executive Director. “These recommendations strengthen Medicare policies to ensure that beneficiaries are fully aware of and can benefit from these innovative care models.”    Check out the articles here:   👉 https://lnkd.in/dQ6yGefT  👉 https://lnkd.in/dDneAnrU

Check out the Health Care Transformation Task Force's resource on the Centers for Medicare & Medicaid Services ACO Primary Care Flex Model. The resource is intended to provide a helpful overview of the new model breaking down:  ▶ Model Goals   ▶ Eligibility & Participation  ▶ Financial Methodology    ▶ Health Equity   ▶ Quality Measurement  Read the resource here: https://lnkd.in/eVBvcbdq    👉 This is the newest resource in a collection of briefers on policies and CMMI models that amplify how value-based payment is changing our health care system for the better. Check out the collection here: https://lnkd.in/edTbnqr4 

By 2030, the Center for Medicare and Medicaid Innovation aims for all Traditional Medicare beneficiaries and most Medicaid beneficiaries to be in accountable care relationships. This involves doctors or hospitals ensuring quality care, coordination, and cost efficiency for patients. Specialty care integration is crucial, with initiatives like data transparency, payment models, and specialist engagement strategies driving progress towards this goal. https://hubs.la/Q02rTwYD0

I’ve talked frequently and urgently about the need to invest in primary care. One of the best ways to address current and emerging threats to our health care system is to move towards a system that better supports and finances high-quality primary care. I wrote about this extensively with Farzad Mostashari in Health Affairs.   Over the past decade, we’ve seen more primary care practices move into alternative payment models that help them care for their patients. The best part is that it’s working: Primary care practices in these new models are improving quality, producing savings and investing in new care delivery strategies that improve patient outcomes and physician satisfaction.   We attribute much of this progress to the combination of the #CMMI and the Centers for Medicare & Medicaid Services Medicare Shared Savings Program. Read more: https://lnkd.in/ePE_mhE6

Primary care in the United States faces a crisis due to underinvestment, resulting in shortages and practice closures.   The Centers for Medicare & Medicaid Services (CMS) has introduced the voluntary Making Care Primary (MCP) model and a new add-on code (G2211) to enhance primary care in underserved communities. However, only 5-7% of healthcare spending is allocated to primary care, leaving a quarter of residents without adequate access.   Increasing primary care investment, adopting a hybrid payment model, and leveraging the Medicare Shared Savings Program (MSSP) are essential to improving patient health and reducing costs in the long term.   Our team so professionals collaborating with healthcare organizations, payers, and policymakers to implement value-based care, streamline billing processes, and improve care access.   Together, we can improve clinical and financial outcomes for our communities' healthcare providers, companies, and systems!   We are the One!   https://lnkd.in/gTgRcZC4   #revenuecycle #revenuecyclemanagement #priorauthorization #medicalbilling #medicalcoding #healthcare #healthcaretechnology #accountsreceivables #denialmanagement #consulting #management #implementationpartner Medical Economics

The recently released Health Care Transformation Task Force and National Association of ACOs resource on Reimagining Beneficiary Engagement in Accountable Care Models was featured in Medical Economics and Xtelligent Healthcare ! This resource outlines policy recommendations for the Centers for Medicare & Medicaid Services aimed at strengthening patient engagement in ACO governance, care delivery redesign, and individual care planning, with a particular focus on Medicare Accountable Care Organizations (ACOs).      “Effective patient engagement is paramount to the success of ACOs,” said Jeff Micklos, Task Force Executive Director. “These recommendations strengthen Medicare policies to ensure that beneficiaries are fully aware of and can benefit from these innovative care models.”    Check out the articles here:   👉 https://lnkd.in/dQ6yGefT  👉 https://lnkd.in/dDneAnrU 

There are many barriers to reducing physician shortages in Tribal communities and payment is one of them. Building up the resources to encourage physician residents and fellows (GME) to serve in I/T/U facilities is the critical first step. However, we also want those physicians to stay and continue providing high-quality care in Tribal medical facilities and that requires payment reform. Leaders from the Centers for Medicare & Medicaid Services Innovation Center (CMMI) recently released an update discussing the center's work on advancing health equity through value-based care. We're grateful for CMMI's work, which includes testing value-based care payment models and payment adjustments that help to better resource health care providers in underserved communities, including Tribal medical facilities. These are important steps to bring more providers to I/T/U facilities. Purva Rawal; Semret Seyoum; Liz F. https://lnkd.in/eXrpC5Je

Given the progress we’ve made in advancing well-designed value-based primary care, we should broaden our focus beyond aggregate reductions in spending in Medicare (or any other single program) and evaluate whether we are enabling the kind of care delivery transformation that improves outcomes, advances health equity, and will attract the next generation of primary care clinicians. Specifically, Farzad Mostashari and I recommend that we examine models that: 1) Support and sustain independent primary care practices in diverse communities. Value-based payment models should increase competition, not accelerate consolidation, and models must be intentionally designed to bolster community-based primary care. 2) Enable primary care teams to optimize care and meaningfully improve patient outcomes, including those reported by patients themselves. Well-designed value-based primary care payment models give practices the financial support and operational flexibility they need to best support patients and physicians. 3) Make primary care more accessible and affordable for patients. Primary care should serve as the front door to the health care system, providing patients with a trusted, low-cost setting where most of their health care needs can be addressed. https://lnkd.in/ePE_mhE6

Read this to get familiar with the AHEAD, GUIDE and MCP models. #valuebasedpayments #CMS

Elizabeth Fowler, Sarah Fogler, Claire Schreiber, Brian Waldersen, Genevieve Kehoe, Rachel Roiland, Sacha Wolf, Anna Goldman, and Purva Rawal from the Centers for Medicare & Medicaid Services discuss how the CMS Innovation Center has laid out a comprehensive specialty strategy to test models and innovations that support access to high-quality, integrated specialty care across the patient journey. "The first element of the Innovation Center’s specialty strategy aims to deliver enhanced specialty care data to clinicians, hospitals, and other health care entities across multiple models and programs. This requires a coordinated rollout of multiple data initiatives to support different kinds of providers and/or participants. The framework for data coordination and transparency is based on a survey of Accountable Care Organizations (ACOs) and advanced primary care model participants that asked what additional data would support specialty care engagement." Read the full article here: https://bit.ly/43LvZJN