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Below are Intelligence Briefs available to anyone.
April of 2022, the GTMRx Institute and the Institute for Advancing Health Value co-hosted an executive roundtable, Optimizing Medication Use for Accountable Care Success. The primary objective of the event was to facilitate discussion between value-based care leaders about the importance of optimizing medication use through comprehensive medication management (CMM) in practice through clinical teams working within alternative payment models (APMs). This report is a value-based care resource derived from the event and is open access once you complete the form.
This brief provides context for the proposed updates, details the rule’s major MSSP-related provisions, highlights industry reactions, and considers the implications of the changes to the landmark ACO program for current and prospective participants and the larger value movement. This brief is open access once you complete the form.
Risk adjustment is an important tool for providers, payers, and other healthcare stakeholders to understand and plan for the needs of a population and is fundamental to delivering value-based care. This brief outlines use cases, reviews commonly-used methodologies, and describes expectations for the future of risk adjustment.
Thank you to our sponsor, 3M
On February 24, 2022, the CMS Innovation Center announced a redesign of the controversial Global and Professional Direct Contracting Model and the launch of a replacement initiative, termed the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model. The application period for this new model – set to begin on January 1, 2023 – opened on March 7, 2022. This brief will help you understand the key changes, new provisions, and potential implications of this revised model for your next step in value.
Thank you to our sponsor, Lumeris
The 2021 Health Care Payment Learning & Action Network Summit provided insight and thought leadership from CMS and others who champion value in health care. This brief summarizes the discussions and the results of the latest Measurement Report for reporting years 2019 and 2020, charting slow but steady progress in the adoption of alternative payment models.
Women make up the vast majority of the health care workforce but are underrepresented in positions of leadership, especially amongst physicians. The differential impact of choices and sacrifices that accompany the profession of medicine are not equitably distributed between men and women. Read this brief to learn more about the value imperative for equity in health care staffing and delivery.
With new leadership, many CMS alternative payment models are coming under intense scrutiny, including the MSSP. Data for the most recent year characterize 2020 as the most successful year for the program, in terms of net savings. This brief describes characteristics associated with ACO success in the MSSP and details a number of implications for the future of the program.
In theory, recent regulations from HHS promote accessibility of price information from hospitals that should aid in comparisons across facilities. The reality is not so clear-cut. Read this brief to learn more about how you might harness hospital price data to inform your value strategies.
Accountable care organization (ACO) models have been the Center for Medicare & Medicaid Services’ (CMS) primary vehicle for value transformation since the start of the movement. Under an ACO model, coalitions of providers agree to assume responsibility for the cost and quality outcomes of a defined population of patients. This brief is a comprehensive evaluation of both the direct contracting and MSSSP risk-based options.
In April 2019, the Centers for Medicare & Medicaid Services (CMS) announced a series of primary care-focused payment models designed to test various approaches to transforming primary care payments to reward value. Called the CMS Primary Cares Initiative, the Innovation Center (CMMI) will test five new payment model options under two paths – Primary Care First and Direct Contracting – each building on existing CMMI models to advance and expand effective elements of value-based payment programs.
Digital health technology is emerging as an imperative in value-based care delivery models. For reasons including safety, geography, patient convenience, and others, digital health apps are gaining in volume and popularity in the market. This brief will keep you apprised of current and future trends in the digital health landscape.