The 2025 CMS PFS Rule landed with a bang, and it’s not just the weight of the 3,088 pages. We’re one year closer to 2030, the year that CMS intends to have all Traditional Medicare patients in a relationship with a clinician who is accountable for total cost of care. The push to the finish […]
Your ACO May Already Be Late for APP Reporting. Here’s How to Catch Up!
With one year remaining before mandatory APP Reporting in 2026, the idea that you’re already late may sound exaggerated. But consider the significance of what you’re undertaking: This is your first effort to report quality on all your beneficiaries, not just a tiny sliver of patients. It’s a huge leap that requires a lot of […]
To Unlock ACO Access to Real Savings, Start with Trusted Data
Value-Based Care payment models are based on a clear CMS goal: lower Total Cost of Care and its counterpart, Total Per Capita Cost. But neither TCoC nor TPCC gives you the information you need to target your cost efforts. How to start? Begin by evaluating what initiatives you need to do in the five key […]
5 Ways Your ACO Should Leverage Data for Cost Control
In creating your strategies for cost control, your ACO must consider how to reduce Total Per Capita Cost (TPCC) while ensuring the financial survival of your ACO and participating providers. This balancing act is the dilemma facing all providers adopting Value-Based Care: how to achieve more savings while replacing revenue lost from services. Here’s how […]
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 […]
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 […]
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 […]
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 […]
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. […]
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 […]