In a previous post, we demystified the Alternate Payment Model Performance Pathway (APP) and explained how, by partnering with a Clinical Data Registry experienced in data aggregation and result submissions to CMS, you can avoid the bugaboos falsely attributed to APP reporting—perceived high costs and impossible timelines. Here we’ll show you how to leverage your […]
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 […]
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 […]
Supercharge Your Way to Value-Based Care
Whether you are an ACO, a health system considering value-based payment, or a medical group weighing your options for Value-Based Care, Roji’s new eBook, Supercharge your ACO for Top Value, has the strategies you need to reduce the cost of care and get clinician backing for innovation. The health care market’s reconfigured landscape puts ACOs—and […]
ACOs: Scale Up Data to Achieve APM Success
Last updated July 27, 2022 More data is required for ACOs, now that Alternative Payment Models have moved to high gear. In this article we’ll take the mystery out of how to realistically gauge your data needs and scale up data, so that your ACO can be successful. We’ll show you how to identify the […]
Video: How to Engage Specialists Through Centers of Excellence
Specialists will engage in cost performance improvement if they believe they can provide better care for their patients and improve their own clinical excellence. Here’s how to achieve that through Episodes of Care, and how ACOs and health systems can help. You’ll find more details in last week’s post, Five Ways to Manage Specialty Costs […]
Three Fixes for ACOs’ Physician Engagement Strategies
ACOs know that reducing costs is the key goal for Value-Based reimbursement. But strategies on how—or even whether—to engage physicians in that goal have not always been successful, to the detriment of all involved. Part of the problem is that provider revenues still stem from Fee-for-Service payments. Physicians are still rewarded based on meeting volume […]
The Interim ACO Rule Explained: A Pause, Not a Reprieve
As the coronavirus pandemic continues to upend health care in the U.S., pressure has mounted on CMS to adjust its efforts to drive providers to adopt risk. In response, at the end of last week CMS announced a carve-out of COVID-19 patient expenses from certain reporting requirements. In this round, ACOs were on the receiving […]
Could AI Push Sales of Personal Health Data? How to Protect Consumers While Advancing Science
We are just beginning to see the power of Artificial Intelligence (AI) in medicine and management of conditions. AI is being used to enhance and speed diagnostic capabilities in conjunction with wearable devices as well as to identify health care cost issues and high risk patients. Companies, health care providers, and researchers hoping to move […]