Jordan Anderson, MD, MBA’s Post

The ACO Primary Care Flex Model aims to ease financial burdens for low revenue ACOs while encouraging tailored patient care and a focus on health equity, CMS said. One-time advanced shared savings payments of $250,000 are meant to help providers with the costs of forming an ACO, as well as administrative costs tied to program participation, according to a news release. The monthly, prospective payments would replace Medicare fee-for-service pay for primary care. #valuebasedcare https://lnkd.in/gZiTK8iX

Update from CMMI on the efforts to have all traditional Medicare beneficiaries in accountable care plans by 2030: CMS’s 2030 accountable care goals will be achieved through the alignment of Innovation Center models and changes to, and growth in, Medicare programs and payment systems. Recent proposed changes to the Medicare Shared Savings Program and the Medicare Physician Fee Schedule demonstrate how CMS intends to scale Innovation Center findings in the Medicare program. However, achieving the goal of 100 percent of traditional Medicare beneficiaries in an accountable care relationship will require continued collaboration with providers and beneficiaries. Taking steps to translate lessons learned and improve the sustainability of value-based and accountable care can improve and strengthen traditional Medicare for all beneficiaries. https://lnkd.in/efFdhTas

Check out the Health Care Transformation Task Force's resource on the Centers for Medicare & Medicaid Services ACO Primary Care Flex Model. The resource is intended to provide a helpful overview of the new model breaking down:  ▶ Model Goals   ▶ Eligibility & Participation  ▶ Financial Methodology    ▶ Health Equity   ▶ Quality Measurement  Read the resource here: https://lnkd.in/eVBvcbdq    👉 This is the newest resource in a collection of briefers on policies and CMMI models that amplify how value-based payment is changing our health care system for the better. Check out the collection here: https://lnkd.in/edTbnqr4 

The Centers for Medicare & Medicaid Services (CMS) is launching a new program specifically aimed at improving primary care delivery. This voluntary initiative, called the ACO Primary Care Flex Model (ACO PC Flex), starts in 2025 and targets smaller, physician-run ACOs participating in the Medicare Shared Savings Program (MSSP). The ACO PC Flex Model offers financial incentives to participating ACOs to invest in innovative, team-based care approaches. This could mean more telehealth options, better chronic disease management, and a focus on preventive health for patients. Overall, this program aims to empower primary care providers, improve health outcomes, and potentially reduce healthcare costs. Learn more about the ACO PC Flex Model and its potential impact 👉https://hubs.la/Q02qsj0b0 #valuebasedcare #healthcareinnovation

Opportunities to Improve PCP Care Coordination for both Medicare Advantage and Traditional Medicare Patients The Commonwealth Fund published research findings this week comparing care coordination among Medicare Advantage patients compared to traditional Medicare patients. They found few differences in care management for patients with chronic conditions, including treatment plans and written instructions to patients on managing their own care at home. These research findings point to an opportunity for plans to provide resources to PCPs to manage their patients more efficiently. Specifically, plans should enable efficiencies to contact patients between visits to monitor their conditions. Vironix offers exactly that efficiency with our AI-enabled virtual care management services. Our software provides patients, caregivers, and care teams with real-time updates on patient vitals . Our care teams communicate with both patients and their physician’s teams to avoid condition deterioration, hospitalizations, and emergency room visits. Our care management services provide efficiencies to avoid staff and caregiver burnout. Contact us at [email protected] for more information. #medicareadvantage #remotepatientmonitoring, #healthcareai #healthcareinnovation #remotepatientmonitoring #remotehealthcare Sumanth Swaminathan Botros T.s Ram Reddy Sriram Ramanathan Jatin Rajput Christopher Chew Nicholas Wysham Chris Landon Mahesh Visvanathan Emily Twanmo, MBA, MHS Andrew Paolillo Jeff Hanson, MPH Shadin Hilton MS, MBA, RNC, PMP, CPHQ https://lnkd.in/gCdvpPet

The recently released Health Care Transformation Task Force and National Association of ACOs resource on Reimagining Beneficiary Engagement in Accountable Care Models was featured in Medical Economics and Xtelligent Healthcare ! This resource outlines policy recommendations for the Centers for Medicare & Medicaid Services to strengthen patient engagement in ACO governance, care delivery redesign, and individual care planning, focusing on Medicare Accountable Care Organizations (ACOs).      “Effective patient engagement is paramount to the success of ACOs,” said Jeff Micklos, Task Force Executive Director. “These recommendations strengthen Medicare policies to ensure that beneficiaries are fully aware of and can benefit from these innovative care models.”    Check out the articles here:   👉 https://lnkd.in/dQ6yGefT  👉 https://lnkd.in/dDneAnrU

🚨 Big News in Healthcare Payment Reform! 🚨 Senators Sheldon Whitehouse (D-RI) and Dr. Bill Cassidy (R-LA) have introduced the Pay PCPs Act to revamp how primary care providers are compensated under Medicare. This legislation aims to address the primary care physician shortage, enhance patient outcomes, and reduce healthcare costs. Key points include: - Hybrid payment models rewarding quality care. - Reduced cost-sharing for Medicare beneficiaries. - Establishing a technical advisory committee for accurate fee schedules. Let's drive the change towards a healthier future! 🌟

On July 10, 2024, CMS released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year 2025. In addition to the agency’s suggested cut to physician payments, the proposed rule also announced new covered services. According to CMS, the proposed rule “reflect[s] a broader Administration-wide strategy to create a more equitable health care system that results in better accessibility, quality, affordability, empowerment, and innovation for all Medicare beneficiaries.” Read the recent HC Topics article for more: https://lnkd.in/gGzfp_Hs For more updates in healthcare, be sure to subscribe to the HC Topics e-journal here: https://lnkd.in/g4VS2F7r and for more information about HCC, visit www.healthcapital.com #MPFS #CMS #Medicare #healthcare #HCTopics

CMS Proposed Rule for CY 2025 Medicare Physician Fee Schedule - HIT Consultant Title: CMS Proposed Rule for CY 2025 Medicare Physician Fee Schedule #Overview The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule for the Calendar Year (CY) 2025 Medicare Physician Fee Schedule. The rule includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule. #Key Changes CMS is proposing changes to the payment rates for evaluation and management (E/M) services, telehealth services, and other codes. The proposed rule also includes updates to the Quality Payment Program and the Merit-based Incentive Payment System (MIPS). #Telehealth Services The proposed rule would make certain telehealth services permanent beyond the public health emergency. CMS is ai.mediformatica.com #medicare #physician #proposedrule #coding #acceibility #administration #affordability #better #healthcare #healthcaresystem #innovation #january #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3YmLuaD)

The recently released Health Care Transformation Task Force and National Association of ACOs resource on Reimagining Beneficiary Engagement in Accountable Care Models was featured in Medical Economics and Xtelligent Healthcare ! This resource outlines policy recommendations for the Centers for Medicare & Medicaid Services aimed at strengthening patient engagement in ACO governance, care delivery redesign, and individual care planning, with a particular focus on Medicare Accountable Care Organizations (ACOs).      “Effective patient engagement is paramount to the success of ACOs,” said Jeff Micklos, Task Force Executive Director. “These recommendations strengthen Medicare policies to ensure that beneficiaries are fully aware of and can benefit from these innovative care models.”    Check out the articles here:   👉 https://lnkd.in/dQ6yGefT  👉 https://lnkd.in/dDneAnrU