Category Archives: Healthcare Utilization

‘Next Generation’ ACO Encourages Telehealth, Post-Discharge Home Services: CMS

In another step towards advancing models of care that reward value over volume, HHS announced the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery. A new initiative from CMS’s Innovation Center, the model is part of … finish reading ‘Next Generation’ ACO Encourages Telehealth, Post-Discharge Home Services: CMS

Posted in Accountable Care Organizations, affordable care act, Alternative Healthcare Coverage, Care Coordination, Care Transitions, Disease Management, dual eligibles, Elderly Care, Healthcare Costs, Healthcare Utilization, Home Healthcare, Medicare/Medicaid EHR Incentive, Skilled Nursing Facilities, Telehealth | Tagged , , , , | Leave a comment

CMS 2015 Impact Assessment of Quality Measures: Healthcare’s Triple Aim Improved

Results from the 2015 National Impact Assessment of Quality Measures Report (2015 Impact Report) demonstrate progress in improving healthcare’s Triple Aim, and impacts populations beyond Medicare, according to the CMS. The report is a comprehensive assessment of quality measures used … finish reading CMS 2015 Impact Assessment of Quality Measures: Healthcare’s Triple Aim Improved

Posted in affordable care act, Avoidable Hospitalization, CMS Acute Care Episode, Disease Management, dual eligibles, Elderly Care, Healthcare Costs, Healthcare Utilization, Population Health Management | Leave a comment

2015 Hospital Market Will Hasten Transition to Value-Based Payment Business Model

The 2015 economic outlook for the hospital industry continues to favor the largest, most geographically diverse health systems in the market, according to a new forecast from BDC Advisors, a national healthcare consulting firm. The positive outlook for large non-profit … finish reading 2015 Hospital Market Will Hasten Transition to Value-Based Payment Business Model

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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

Frequent Home Visits Reduce Heart Failure Readmissions, Improve Survival

Frequent home visits combined with multidisciplinary heart failure clinic interventions can reduce hospital readmission and improve survival for patients with heart failure, according to research from RTI International and the University of North Carolina at Chapel Hill. The number and … finish reading Frequent Home Visits Reduce Heart Failure Readmissions, Improve Survival

Posted in Cardiac Care, Healthcare Spending, Healthcare Utilization, Home Healthcare | Tagged , , | Leave a comment

Telemedicine, Home Health Beneficiaries of New Medicare Frontier Payment Program

Enhanced Medicare payments for telemedicine and home health services are among the goals of a new Frontier Community Integration Project Demonstration, according to program FAQs released by the CMS. Critical access hospitals (CAHs) that receive funding through the Rural Hospital … finish reading Telemedicine, Home Health Beneficiaries of New Medicare Frontier Payment Program

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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

Posted in affordable care act, Healthcare Quality and Access, Healthcare Reform, Healthcare Utilization, Patient-Centered Medical Home | Tagged , , , , , | Leave a comment

40 Percent of Health Plan’s Star Rating Attributed to Regional Variation

Nearly 40 percent of a health plan’s CMS Five-Star Quality rating can be explained by the quality of the providers in a given county or region, says Joseph Johnson, vice president of L.E.K. Consulting. Here he points out where those … finish reading 40 Percent of Health Plan’s Star Rating Attributed to Regional Variation

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