by Amanda Brown, MHA, Molly Johnson, MHSA and Amanda Kueh
Becker's Hospital Review
March 2018
What CMS bundled payment initiative are we on? It can be hard to keep track. First there was the Bundled Payments for Care Improvement (“BPCI”) model, a voluntary bundled payment program beginning in 2013. Then in 2016, CMS introduced the CJR (Comprehensive Joint Replacement) bundled payment model, which was initially mandatory in 67 MSAs […]
by John M. Harris, Director & Idette Elizondo, Manager
Accountable Care News
December 21, 2017
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by William Hamilton, Manager
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Accountable Care Organizations (“ACOs”) receive a substantial portion of their revenue through shared savings programs in which payers pay the ACO a portion of total cost savings generated by member providers through effective care management. The ACOs then distribute part of the shared savings to participating healthcare providers, based on a distribution formula; the remainder […]
by Idette Elizondo, Manager; Amanda Brown, Senior Associate;
& Alexandra D'Innocenzo, Associate
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Despite many uncertainties, the shift toward value based payment continues. More Medicare Shared Savings Program (MSSP) ACOs have entered risk-based tracks (Tracks 2, 3, and now Track 1+), to take advantage of MACRA’s[1] 5% bonus to physicians in risk-based payment models. The latest numbers about exactly how many have selected risk for next year will […]
by Molly Johnson, Manager & Alexandra D'Innocenzo, Associate
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Clinically Integrated Networks (CINs) need quality data to understand their patient population and manage provider practice patterns. That makes information technology (“IT”) critical at any stage of CIN development. For CINs with a mix of employed and independent physicians, IT is likely to be a tale of two cities – the employed physicians have solid, […]
by Amanda Brown, Senior Associate; Idette Elizondo, Manager; John Harris, Director
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CMS wants more physicians to participate in ACOs and other alternative payment models (APMs). It’s best if they are risk-taking ACOs, but any ACO seems to be better than none. At least, that is what the incentives in MACRA seem to indicate. Prior to the passage of MACRA (the Medicare Access and CHIP Reauthorization Act […]
by John M. Harris, Director, and Craig E. Holm, Director
hfm Blog
July 2016
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John M. Harris and Craig E. Holm describe howimplementation of MACRA bring significant strategic implications for hospitals and health systems as well and physicians.
by Molly Johnson, Manager & Danielle Bangs, Senior Associate
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Physician engagement is critical to CIN success. True engagement, however, takes vigilance and a long-term commitment; having physicians join your network is just the beginning of the process. Our experience has shown that, despite their best intentions, many CINs lose touch with their physician membership at some point along the road. Effectively engaging physicians in […]
by John M. Harris, Director, Idette Elizondo, Manager, & Amanda Brown, Associate
HFM Magazine
March 1, 2016
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Accountable care organizations are at the forefront of the healthcare industry’s transition to value-based care; those that succeed will provide a leading example for the industry to follow.