At first glance, CMS’s recently released 2022 QPP Experience Report (PDF) seems reassuring, because the majority of clinicians avoided financial penalties under MIPS. Don’t be fooled! While overall success and failure rates in the report may lead you to conclude that merely participating in the QPP (either in MIPS or as an APM) is enough […]
Jumpstart ACO Health Equity with Data-Based Collaborative Initiatives
Ever since the first pandemic data revealed the enormous cost of health inequities, the pressing question of how to rectify unfair access to quality health care has become a major policy discussion. Now the debate is turning to action, as the first Value-based Payment Model to address health equity comes online. ACO REACH is Medicare’s […]
How to Define Your Transition Strategy to APM Success
Health care systems that have struggled to survive pandemic pressures won’t get a reprieve from competition any time soon. Since Covid shook the world, private investors in health care delivery have emerged as the most potent force driving change in delivering Value-Based Care. Equity-backed medical groups, ACO enablers with venture capital funding, and corporate health […]
No Worries About ACO APP! It’s Your Pathway to Improvement
With the release of the 2023 Physician Fee Schedule Final Rule, CMS upheld its commitment to sunset its Web Interface for ACO quality reporting after 2024. Beginning in 2025, ACOs will be required to report through the Alternate Payment Model Performance Pathway, or APP. Some have expressed concerns about the APP. But this new reporting […]
Launch Time! Five Intervention Strategies to Fuel Your APM Liftoff
If you’ve followed the Smart Guide articles so far, your APM is ready for take-off. You’ve developed a data-sufficient technology infrastructure with both provider and claims data, carefully constructed your clinical network and engaged your clinicians, and implemented strategies for payers and consumers. Your APM may be operating already, with data ready to use. Now […]
Need to Fire Up Your APM’s Consumer Strategies? Start Here
You’ve read it and you’ve experienced it: consumer frustration with an impersonal health care bureaucracy offering few conveniences, difficult navigation, high cost, and lack of transparency. Even as some organizations try to move forward with consumer-focused strategies, these are often still fledgling efforts with little overarching structure that fail to attract consumer attention. Beyond implementing […]
3 Ways to Engage Physicians to Lead Transformation in Your APM
Doctors leaving medicine spells trouble for health care. And there’s real reason for concern. A few weeks ago, the Mayo Clinic released its most recent study on physician burnout, revealing the highest rate in the survey’s 10-year history. Sixty-three percent of responding physicians reported one or more characteristics of burnout, with many noting depersonalization, an […]
Eight Key Strategies for APM Contracting Right Now
Are you considering entering into APM contracts with private payers? Bravo! Teaming with commercial health plans and employers is a strong opportunity for growing patients through APM arrangements. Expanding your APM agreements into all payment types will be essential to back the incentives you build into your workforce for performance-based pay. But those contracts must […]
Your Smart Guide for APM Success
In the next several years, one of two things will happen: Either traditional health care providers will make the largest, make-or-break transformation of health care system economics and delivery of care in U.S. history, or the legacy health care system as we know it will not survive, but will be absorbed into the new corporate […]
Three Key Decisions to Direct Your APM Adoption Strategy
How you ramp-up to full-scale APMs is crucial. Even if your multi-specialty group or health system receives some value-based payments with downside risk, your success hinges both on financial viability and retention of your clinicians and patients. If you delay APM adoption only after reviewing the potential on your bottom line, you’ll need to pay […]