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CMS offers various ACO models such as MSSP, ACO REACH, and Primary Care Flex, designed to improve healthcare quality while lowering costs. Each model provides different levels of risk, reward, and flexibility, making them appealing to a wide range of providers. These ACO options are crucial for reaching the goal of having all Medicare beneficiaries in accountable care relationships by 2030. With the ACO REACH model scheduled to end in 2026, CMS should begin developing its transition plan for those organizations, prioritizing the continuation of key features that have proven successful in improving care and lowering costs. CMS should have a range of ACO model options so that providers can select the option that best fits their patient population and practice needs. To learn more, read our recent issue brief: https://lnkd.in/eBXVH5my

The growing tension between Medicare Advantage plans and healthcare providers is a critical issue that will continue to shape the healthcare landscape in the coming years. As insurers tighten networks and cut costs to navigate regulatory pressures, rising medical expenses, and competition, providers are increasingly opting out of contracts. This dynamic has left patients in limbo, facing potential disruptions in care and higher out-of-pocket costs. Agencies and marketers need to recognize the implications of these shifts: the Medicare Advantage market will likely see continued volatility, with both insurers and providers vying for leverage in an increasingly strained ecosystem. For marketers, understanding these evolving relationships will be key to addressing the concerns of patients and providers alike, while also adapting messaging strategies to reflect the changing realities of Medicare Advantage. https://lnkd.in/gEFPn6pw

Thank you. Farzin A. Espahani, for sharing this article highlighting the critical need to address the issues healthcare systems are experiencing when choosing to care for patients with MA plans. Common issues: slow reimbursement and delays in care based on the need for prior authorization or access to in-network providers Combine this with concerns that in the value-based care setting, MA plans are coming in at higher per-patient costs. Greatest Concern: The patients caught in the middle loosing access to care. #PatientsFirst

Fewer than 5 cents of every dollar spent on healthcare in the US goes to primary care, yet we know that investment in primary care reduces overall healthcare costs. According to this article, in 2022 Medicare Shared Savings Programs saved CMS $1.8 billion and ACO REACH saved $371 million. Continued focus on additional investments in primary care will be most importantly better for our patients but also will help curb the ever-increasing cost of healthcare in this country.

📰 Breaking News: Medicare Accountable Care Organizations can now access CMS shadow bundle data! Read our latest blog to learn why this is a unique opportunity for ACOs and clinically integrated networks. https://loom.ly/w6Hm9KE #DataGen #ACOs #CMS #AccountableCareOrganization #Medicare #Healthcare

The potential for value-based care to reduce administrative burdens and improve patient outcomes is becoming a reality as payers step up. Initiatives like payment integrity reforms and simplified claims processing are helping physicians focus on what truly matters: patient care. By continuing to enhance these support structures, we grow closer and closer to making VBC the standard for healthcare excellence. #VBC #ValueBasedCare #Healthcare

We have been discussing value-based healthcare for almost 25 years. How much longer will it take for VBC to mature as a program or model in the United States? Value-based care links healthcare provider earnings to the results they achieve for patients, focusing on quality, equity, and cost. These programs hold providers accountable for patient outcomes and offer flexibility in care delivery. #valuebasedcare #healthcaretransformation #CMS #Macra #Primarycarecareinititatives #QualityPaymentAct2015 #acronymindustry #healthcarepatientoutcomes #populationhealthmanagement

With the ever-evolving landscape of healthcare, it is crucial, for healthcare practitioners to stay informed about the latest payment systems and regulations. One such system that practitioners need to be familiar with is the Merit-based Incentive Payment System (MIPS). Learn more about MIPS 2024: A Comprehensive Guide for Healthcare Practitioners https://ow.ly/Yx6u50QVO4f #MedISYSMIPS #GOMediSYSMIPS

Federal price transparency rules now require hospitals and insurers to disclose negotiated rates, promoting greater transparency in healthcare costs. This initiative aims to reduce the wide variations in prices for the same services. By empowering patients with clear information and incentives, we can encourage smarter shopping for healthcare, potentially driving down costs and improving affordability. It's a great step, but not the only one needed to address inefficiencies. UHC continues to be leader in providing our members with the tools and resources to navigate a complex healthcare system. This includes innovative products like Surest and strategic partners like Garner Health #Healthcare #PriceTransparency #PatientEmpowerment

Learn how value-based care incentivizes the quality of patient care over quantity, benefiting both the patient and the provider. #BusinessOfHealthcare #ValueBasedCare 🔔 Don’t miss any of our posts, tips, or insights about the business of healthcare. Click the bell underneath the banner on the right-hand side to get notified as soon as we publish!