APP Reporting, APP Measures, health care cost savings
ACOsAPP ReportingData Best PracticesValue-Based Health Care
March 4, 2024

3 Ways Your ACO Can Convert APP Reporting Data into Higher Savings

Controlling costs is a key Value-Based Care goal, a fact well-known to ACOs that share savings with CMS. Even as individual ACOs have generated tens of millions of dollars in savings, however, MSSP ACOs as a whole have only been able to reduce their Total Cost of Care (TCOC) by a fraction. That is a program vulnerability and one reason why value-based payments are increasingly incorporating population-based payment. Plainly stated, claims data (especially 2-5 months old) isn’t a great tool for identifying patient risks, Medicare HCCs notwithstanding. The timeline for cost prevention is before events occur, not when you’re looking…
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Roji Health Intelligence 2024 Health Care Trends Theresa Hush
Artificial IntelligenceConsumers & PatientsCorporate Health CareData Best PracticesFuture of Health CareValue-Based Health Care
January 25, 2024

These Five Trends Are Steering Your Future Path to Value-Based Care

Buckle your seat belt. Health care is changing at warp speed. The Value-Based Care movement and leaps in technology and Artificial Intelligence are rapidly generating advances that will transform the health care environment. These factors will redefine health care providers and services, and how consumers access them. How you respond strategically will determine your survival as a health system, ACO, and health care provider. All of this rests on one essential fact: Value-Based Care in 2024 has graduated from a voluntary movement into certainty. There is arguably no one in health care who believes that there is an “out.” While…
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Roji’s customized APP Reporting Plan enables your ACO to meet highest quality Medicare APP reporting standards through our qualified registry, to meet Value-Based Care, while dramatically reducing reporting costs and creating actionable data.
ACOsAPP ReportingData AggregationValue-Based Health Care
January 11, 2024

Customized Roji APP Reporting Plan Cuts ACO Costs and Burden, Boosts ACO Capabilities

Start your APP Reporting of Medicare CQMs and save with Roji Health Intelligence’s customized APP Reporting Plan for ACOs. Our new service enables your ACO to meet the highest quality reporting standards through our qualified registry, while dramatically reducing reporting costs and creating actionable data for use in population health, equity, and cost performance. What’s at Stake for Large ACOs? The finalized Medicare PFS Rule released in November 2023 toppled a big barrier for 2024 ACO quality reporting. CMS provided an option to allow ACOs to report measures for Medicare patients only—and of most importance, created the avenue to identify…
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ACOsAPP ReportingCMS RulesMedicareValue-Based Health Care
December 12, 2023

How Your ACO Can Optimize APP Reporting Using Medicare CQMs

ACOs just gained a reprieve from implementing all-patient APP quality reporting in 2024. A provision in CMS’s Physician Fee Schedule Final Rule, which goes into effect on January 1, 2024, enables ACOs to report on Medicare patients only, based on CMS provision of eligible patient lists for three APP measures. If your ACO decides to delay aggregation of practice data for now, you need to consider how to optimize APP Reporting of Medicare CQMs. Choose a qualified registry for APP Reporting that can reduce your workload for reporting Medicare CQM Measures. Using CMS’s list of patients eligible for measures will…
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The 2024 CMS PFS Final Rule: Post-PHE, Value-Based Care Returns to the Forefront, Roji Health Intelligence, Dave Halpert
ACOsCMS RulesData AggregationMIPS Value PathwaysValue-Based Health Care
November 9, 2023

The 2024 CMS PFS Final Rule: Post-PHE, Value-Based Care Returns to the Forefront

The 2024 Physician Fee Schedule Final Rule—all 2,709 pages worth—was released on November 3, and the significance of the “Post-COVID” rule cannot be understated. With the Public Health Emergency expiring earlier this year, these finalized policies are intended to get the proverbial train back on its tracks, following the massive derailment in March 2020. Although many policies were finalized as proposed, there are plenty of exceptions and caveats, and providers and practices need to be keenly aware of the details. CMS is using this rule to advance its value-based care goals through data aggregation and attention to health equity. Those…
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ACOsEpisodes of CareSpecialty ServicesValue-Based Health Care
November 8, 2023

5 Tips for a Win-Win Collaboration Between ACOs and Specialists

As Value-Based Care expands, payers are emphasizing cost reduction all the more. Newer CMS payment models like ACO REACH reinforce cost control by capping reimbursement in total global payments to ACOs. In turn, global payments enable ACOs to directly negotiate rates with preferred provider specialists. In addition to focusing on controlling costs delivered through primary care, your ACO should pursue strategies to stem total patient care costs (TCC) through specialty services. Between 40 to 60 percent of total patient care costs are driven by specialty physicians. While rate negotiations address the price of individual specialty services, the greater opportunities lie…
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Roji Health Intelligence Three Tips APP Reporting Approach ACOs Value-Based Care
ACOsAPP ReportingData AggregationValue-Based Health Care
August 11, 2023

Three Tips for Choosing Your APP Reporting Approach

If CMS’s new proposed option for APP Reporting becomes part of the Final Rule, ACOs will have the ability to limit quality reporting to Medicare patients only. Your ACO must now determine whether reporting Medicare-only patients saves work and money and best demonstrates your quality. Use these Roji TIPS to decide what approach will work for you. Considerations for Choosing Medicare CQMs versus All-Patient Reporting ACOs have resisted APP Reporting to avoid data aggregation from different physician EHRs. ACOs also want to limit their work to the core of Medicare patients included in the ACO. The following considerations are key…
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Roji TIPS APP Reporting data aggregation ACOs
ACOsAPP ReportingData Best PracticesValue-Based Health Care
July 27, 2023

New for ACOs: Roji TIPS for Implementing APP Reporting

With the advent of APP Reporting, ACOs face a fundamental change in not only how they report quality measures, but also how they use data to drive results. That's true whether APP Reporting involves reporting quality for all patients or for Medicare-only patients via Medicare CQMs. Data is an asset that ACOs have never had. But data has the potential to influence all ACO functions and its success. Rather than depending on past admissions and ER utilization to retrospectively contact patients, ACOs that initially aggregate data will be able to use it to proactively identify patients who need more specific…
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APM Performance PathwayAPP ReportingCMS RulesData Best PracticesMIPS Value PathwaysValue-Based Health Care
July 19, 2023

The 2024 CMS PFS Proposed Rule: 7 Attempts to Balance Participation Goals with Value

Reading between the many lines in the 1,920-page 2024 Medicare Physician Fee Schedule (PFS) Proposed Rule, one thing is clear: CMS is still struggling to move providers into Advanced Alternate Payment Models (APMs) and keep existing ACOs moving forward on the path to value-based payments. The APP Reporting tug-of-war between CMS and ACOs results in a slight concession for providers worried about difficulty and cost of all-patient APP Reporting. We’ve seen this before, of course. Remember the delay in sunsetting the Web Interface for ACOs in the 2022 Rule and the retreat from mandatory transition to risk in the 2023…
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ACOsAPP ReportingData Best PracticesValue-Based Health Care
June 16, 2023

Don’t Fall for Magical Thinking in APP Reporting

Since the adoption of the 2023 Final Rule requiring ACOs to adopt Alternate Payment Model Performance Pathway (APP) quality reporting by performance year 2025, many ACOs have been scrambling to understand how to make the leap. There’s a huge difference between the old method of quality reporting using the CMS Interface to report on a 248-patient sample and the new requirement for APP reporting on all practice patients, regardless of payer type. The sheer size of reporting volume and mechanics means that your ACO will need to aggregate practice EHR data for the first time, even with fewer measures under…
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