By Sanjay Seth, MD – It was recently calculated the United States spends $3.8 trillion – or 18 percent of the national economy – on healthcare. The current healthcare landscape indicates this spending rate will not slow anytime soon due to the COVID-19 pandemic, an ongoing healthcare crisis.
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By Sanjay Seth MD – ACOs participating in shared savings programs face a number of opposing forces in 2021. From a decline in the number of Medicare beneficiaries to new CMS regulations to force downside risk sooner, ACOs are carefully weighing their options in the year ahead.
By Sanjay Seth MD – Negotiating value-based reimbursement is a complex process for healthcare providers. Organizations need to consider the specific population covered under the contract, the particular reimbursement model used, and which quality and utilization measures will be tracked.
By Sanjay Seth MD – With CMS’s release of the 2020/2021 Shared Savings Quality Measure Benchmarks, here are some insights around how ACOs could be impacted on the cost benchmarking from a historical respective, the regional adjustment and the few benchmarking methods utilized by the commercial payers.
By Sanjay Seth MD – In most parts of the United States, the use of value-based care (VBC) arrangements are growing, and health systems today typically participate in a diverse VBC portfolio. Nevertheless, the proportion of total net patient revenue derived from these programs is usually small.
By Sanjay Seth MD – The COVID-19 pandemic has created great uncertainty for Accountable Care Organizations. From the complete demise of value-based care payment models to loss of shared savings incentives, ACO concerns abound and rumors run rampant.
By Sanjay Seth MD – Medical staff members are often the last to be informed of new risk-based contracts. However, they are usually the first to feel the financial impact of taking on greater risk. With our nation’s medical staff leaders and professionals in mind…
The thought leaders in our community are good about sharing their thoughts on the issues of today. Here are the top read and shared guest posts of January that we think deserve sharing again.
By Sanjay Seth MD – When it comes to the proposed “Pathways to Success” for ACOs participating in the Medicare Shared Savings Program, my suggestion is this: Don’t throw the baby out with the bathwater.