Category Archives: Medicare

One-Fifth to Launch ‘Next Generation’ ACO in 2015

Twenty percent of healthcare organizations plan to participate in CMS’s new ‘Next Generation’ ACO model in the coming year, according to 2015 Accountable Care Organization metrics from the Healthcare Intelligence Network (HIN). About one third of future Next Generation ACOs … finish reading One-Fifth to Launch ‘Next Generation’ ACO in 2015

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Pioneer ACO Results Year 2: Inpatient Utilization Down; Medicare Saves More Than $384 Million

The Pioneer Accountable Care Organization (ACO) Model has generated over $384 million in savings to Medicare over its first two years — an average of approximately $300 per participating beneficiary per year — and significantly decreased inpatient care, while continuing … finish reading Pioneer ACO Results Year 2: Inpatient Utilization Down; Medicare Saves More Than $384 Million

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Humana Accountable Care Snapshot: Reduced Readmissions Among Value-Based Results

Improving access to accountable care is one of four improvements Humana disclosed from ongoing programs to improve quality and reduce costs for Medicare beneficiaries, according to Humana. Humana disclosed results to date from initiatives to foster value-based reimbursement in the … finish reading Humana Accountable Care Snapshot: Reduced Readmissions Among Value-Based Results

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HHS Announces Timetable, Goals for Medicare Value-Based Reimbursement

For the first time in Medicare history, HHS announced explicit deadlines and goals for alternative payment models and value-based payments. According to the newly released announcement, Medicare’s timeline for moving Medicare payments from volume- to value-based is as follows: HHS … finish reading HHS Announces Timetable, Goals for Medicare Value-Based Reimbursement

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Physician Thought Leaders of Tomorrow Must Be Willing to “Rock the Boat”

What kind of individuals are best equipped to engage and lead other physicians in the coming years? Those who are willing to “rock the boat,” and then hold on to the sides of the boat even as it sinks, says … finish reading Physician Thought Leaders of Tomorrow Must Be Willing to “Rock the Boat”

Posted in affordable care act, Alternative Healthcare Coverage, Bundled Payments, Care Coordination, Incentives, Medicare, Physician Alignment, Physician Organizations, Uncategorized | Tagged , , , | Leave a comment

CMS Hopes to Entice More ACOs with Proposed Risk, Rewards Models

Attempting to attract more accountable care organizations (ACOs) to participate in the Medicare Shared Savings Program (MSSP) without fearing penalties, CMS has released a set of proposed rules with updated penalties and incentives, plus a third new model to attract … finish reading CMS Hopes to Entice More ACOs with Proposed Risk, Rewards Models

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Duals Geriatric Care Management: Melding the Medical, Social and Behavioral

When developing a geriatric care management program for the dually eligible, coordinating social and medical components is key, says Timothy C. Schwab, MD, FACP, former chief medical officer of SCAN Health Plan and president and CEO of Tim Schwab Healthcare … finish reading Duals Geriatric Care Management: Melding the Medical, Social and Behavioral

Posted in Behavioral Health, Care Coordination, dual eligibles, Medicaid, Medicare | Leave a comment

CMS to Test Models for Beneficiary Engagement, Incentives, Behavioral Insights

The Centers for Medicare & Medicaid Services (CMS) are seeking input on models to increase engagement among multiple beneficiary populations in health self-management in order to generate better care and better health at lower costs. The Center for Medicare and … finish reading CMS to Test Models for Beneficiary Engagement, Incentives, Behavioral Insights

Posted in Behavioral Health, Disease Management, Incentives, Medicaid, Medicare, Medication Adherence | Tagged , , | Leave a comment

Community Pharmacist Intervention Boosts Medication Adherence, Reduces Healthcare Costs: Study

Community pharmacists can take a greater role in helping their patients adhere to their medication regimens, leading to a reduction in emergency room (ER) visits and hospital admissions, according to a new study led by researchers at the University of … finish reading Community Pharmacist Intervention Boosts Medication Adherence, Reduces Healthcare Costs: Study

Posted in Asthma Care, Avoidable Hospitalization, Cardiac Care, Care Transitions, Diabetes, Disease Management, Medicare, Medication Adherence, Prescription Drugs, Prevention and Wellness | Tagged , , , | Leave a comment

CMS Releases Data on Medicare Providers’ Fees, Services to Mixed Reviews

Reaction to CMS’ public online release of data on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals has been mixed. Specifically, the data released last week includes physicians’ names and addresses, summaries of the services … finish reading CMS Releases Data on Medicare Providers’ Fees, Services to Mixed Reviews

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