Category Archives: Healthcare Reform

Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

Preliminary findings from two advanced primary care initiatives from CMS show decreased hospital admissions and emergency department (ED) visits, CMS officials report. The two large-scale tests of advanced primary care—the Comprehensive Primary Care (CPC) initiative and the Multi-Payer Advanced Primary … finish reading Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

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CMS Releases Final Medicare Payment Rules for Value-Based Modifier, Chronic Care Management

CMS has released final rules outlining how Medicare will pay major healthcare providers and suppliers in 2015, including the Value-based Payment Modifier (VBM), which adjusts traditional Medicare payments to physicians and other eligible professionals based on the quality and cost … finish reading CMS Releases Final Medicare Payment Rules for Value-Based Modifier, Chronic Care Management

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6 Elements of Highmark’s Pay-for-Performance ‘Best Practices’ Project

At Highmark Inc., physicians are eligible for bonus payments across a broad spectrum of measures from clinical and quality measures to prescribing habits, access to care and level of technology use. In addition, practices can also qualify for a bonus … finish reading 6 Elements of Highmark’s Pay-for-Performance ‘Best Practices’ Project

Posted in affordable care act, Comprehensive Primary Care Programs, Healthcare Reform, Healthcare Utilization, pay-for-performance, Physician Alignment | Tagged , , | Leave a comment

Pioneer, MSSP ACOs Save More Than $372 Million, Improve Patient Care: CMS

ACOs in the Pioneer ACO model and Medicare Shared Savings Programs (MSSP) generated more than $372 million in total program savings for Medicare ACOs, according to the CMS. The news is drawn from preliminary quality and financial results from the … finish reading Pioneer, MSSP ACOs Save More Than $372 Million, Improve Patient Care: CMS

Posted in Accountable Care Organizations, affordable care act, Avoidable Hospitalization, Healthcare Reform, Healthcare Spending, Healthcare Utilization, Improving Patient Care | Tagged , , | Leave a comment

Proposed Bill Would Ease Readmissions Penalities for Hospitals That Treat Many Dual Eligibles

A proposed bill in the House of Representatives could ease readmissions penalties on hospitals that treat a high percentage of dual eligible patients if it becomes law, according to the office of Rep. Jim Renacci. The bill, “Establishing Beneficiary Equity … finish reading Proposed Bill Would Ease Readmissions Penalities for Hospitals That Treat Many Dual Eligibles

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Medical Homes Have Limited Impact on Quality, Utilization and Cost: Study

While interventions to transform primary care practices (PCPs) into patient-centered medical homes (PCMHs) are common, but their effectiveness in improving quality and decreasing costs is unclear, according to a study in JAMA. One of the first, largest, and longest-running multipayor … finish reading Medical Homes Have Limited Impact on Quality, Utilization and Cost: Study

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Savings from Medicare ACOs, Pioneer ACOs Exceed $380 Million: CMS

Initial financial results for a number of CMS healthcare reform delivery initiatives are positive, with savings from both the Medicare Accountable Care Organizations (ACOs) and Pioneer ACOs exceeding $380 million, according to the CMS. Interim reports on select Medicare ACO … finish reading Savings from Medicare ACOs, Pioneer ACOs Exceed $380 Million: CMS

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States’ Restrictions on ACA Implementation Hinder Access to Coverage

Community health centers across the country are waging intensive efforts to find and enroll eligible and uninsured patients and community residents, but are hampered by states resistant to healthcare reform, according to the Geiger Gibson/RCHN Community Health Foundation Research Collaborative … finish reading States’ Restrictions on ACA Implementation Hinder Access to Coverage

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FQHCs, Rural Health Clinics Among 123 Newly Minted Medicare ACOs

Doctors, hospitals and other healthcare providers have formed 123 new Medicare ACOs, providing approximately 1.5 million more Medicare beneficiaries with access to high-quality coordinated care across the United States. According to a CMS announcement, the new ACOs include a diverse … finish reading FQHCs, Rural Health Clinics Among 123 Newly Minted Medicare ACOs

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4 Times More Americans Enrolled in Health Insurance Marketplaces in November Than October

Nearly 365,000 Americans selected plans in the Health Insurance Marketplace (HIM) in October and November, and enrollment in November was more than four times greater than October’s reported federal enrollment number, according to HHS Secretary Kathleen Sebelius. Almost 2 million … finish reading 4 Times More Americans Enrolled in Health Insurance Marketplaces in November Than October

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