Alliance for Value-Based Patient Care’s Post

Succeeding in at-risk alternative payment models requires cost transparency awareness at the point of specialist care initiation and subsequent post acute care management. That knowledge translates to narrower spend variations in episode-of-care delivery within patient populations matched by disease severity. BPCI can prove to be a significant first step engagement in at risk contacting prior to the proposed CMS mandatory episodes and value-based referrals impacting specialist group practices in the coming years.

Great reminder from CTAC on the value of Advance Care Planning to Medicare Advantage Medicare Star Ratings. And always important - how we can support the voice of individuals to be the center of all healthcare plans. https://lnkd.in/gzq9wkgC

Discover answers to key questions about the CMS Final Rule 0057-F for payers & providers. Stay compliant and informed with BHM Healthcare Solutions. #payers #providers #compliance Centers for Medicare & Medicaid Services https://lnkd.in/gTEPDfVU

The Centers for Medicare & Medicaid Services (CMS) has issued its proposed policies for the #QualityPaymentProgram applicable to the 2024 performance year. To see what this means for your practice, read our most recent blog "The 2024 Medicare PFS Proposed Rule – MIPS Updates You Need to Know" to learn about the key takeaways! #CMS #MIPS #MIPSUpdates #GovernmentIncentives #healthcarenews https://lnkd.in/exPiPcEw

On November 2nd, The Centers for Medicare & Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule (PFS) ruling. New on the blog, MMG's Ronnen Isakov breaks down the changes and their impact on providers: https://lnkd.in/gHb8QxHD #medicare #healthcare #healthcaremanagement #healthcarebilling

The New Mexico Primary Care Payment Reform Initiative, a mandatory program led by the New Mexico Health Care Authority, marks a significant shift in the state’s Medicaid approach, as it transitions from a volume-based to a value-based payment model. This change is geared towards enhancing the efficiency and quality of health care delivery and introduces new payment structures that will reward patient outcomes and cost-effectiveness. Learn the details of new value-based reporting standards and quality measures organizations will need to meet in this article by Georgia Green, MS, CHFP and Steven Hartley of Moss Adams.

The New Mexico Primary Care Payment Reform Initiative, a mandatory program led by the New Mexico Health Care Authority, marks a significant shift in the state’s Medicaid approach, as it transitions from a volume-based to a value-based payment model. This change is geared towards enhancing the efficiency and quality of health care delivery and introduces new payment structures that will reward patient outcomes and cost-effectiveness. Learn the details of new value-based reporting standards and quality measures organizations will need to meet in this article by Georgia Green, MS, CHFP and Steven Hartley of Moss Adams.

Important opportunities to weigh in on the future of health in Maryland!

🏥📝 Great news for patients and healthcare providers! A bipartisan majority from both chambers of US Congress is urging the Centers for Medicare & Medicaid Services (CMS) to finalize a pending federal regulation that would overhaul prior-authorization requirements within Medicare Advantage. This move aims to increase transparency and improve the prior-authorization process, removing barriers to patients’ timely access to care and allowing providers to spend more time treating patients and less time on paperwork. The congressional majority is also urging CMS to establish a mechanism for real-time electronic prior authorization decisions for routinely approved items and services, require that plans respond to prior-authorization requests within 24 hours for urgently needed care, and require detailed transparency metrics. While prior authorization is often used for cost and quality control, a vast majority of physicians report that the protocols lead to unnecessary waste and avoidable patient harm. This move by Congress is a significant step towards fixing prior authorization within Medicare Advantage. For more details, check out the full article: [ https://lnkd.in/g_32Vwth ] #HealthcareReform #MedicareAdvantage #PriorAuthorization #HealthcareNews #HealthNews #Centerinsuranceandfinancialservices #CIFS #Medicare #Lifeinsurance #Healthinsurance #NMO #Aetna #Cigna #Humana #UHC #Devoted #Anthem #Wellcare #Joinus #Teamwork #Sales #Networking #Smallbusiness #Life #Healthylifestyle

Medicare Advantage is an ideal opportunity to implement new value-based care initiatives. Take care coordination, for example. Encouraging or even incentivizing collaboration among different healthcare providers along a member's continuum of care ensures members receive the right care at the right place at the right time which leads to better health outcomes and efficiency. Although challenges such as communication barriers, lack of patient engagement, rural and underserved populations and fragmented care still exist, Synergy 3C looks to be your partner in identifying and solving for these challenges to transform your VBC offering. Reference: Becker's Payer Issues. (2024, May 20). 10 key questions facing Medicare Advantage. https://lnkd.in/gu_v57iK