Value-Based Care
Alternative payment models are becoming more advanced as the healthcare system transitions to value-based care and payers drive to accelerate generated savings. Track and stay ahead of this evolution to identify strategic partnerships and measure results.
Interview: E2 – CSF Clinical Diagnosis’ Used to Inform Guidance on Detecting Alzheimer’s Disease
Dr. Leslie Shaw, Professor of Pathology and Laboratory Medicine at the Pearlman School of Medicine at the University of Pennsylvania and Chair of the Workgroup that developed the Alzheimer’s Association’s appropriate use criteria for lumbar puncture and cerebral spinal fluid (CSF) testing in the diagnosis of Alzheimer’s disease, discusses how the Workgroup reviewed an extensive body of research on advances in CSF testing to develop the AUC.
Interview: E1 – New Appropriate Use Criteria in Diagnosing Alzheimer’s Disease
We explore the value of the newly released Alzheimer’s Association appropriate use criteria for lumbar puncture and cerebral spinal fluid (CSF) testing in the diagnosis of Alzheimer’s disease. We kick off this series with Dr. Maria Carillo, the Alzheimer Association’s Chief Science Officer and Dr. Jim Hendrix, Director of Global Science Initiatives.
Provider Performance Under Oncology Care Model Varies by Cancer Type
Clinicians who treat certain types of cancer may be better positioned to earn performance-based payments under the Oncology Care Model.
Experienced Medicare Accountable Care Organizations Generate Savings
Assuming risk appears to be a less important factor than experience in predicting ACO success.
CMS Proposal Encourages Advanced Alternative Payment Model Participation
Early adoption and participation in an AAPM can provide a higher incentive payment to Medicare clinicians than MIPS.
Health Plan Interest in Outcomes-Based Contracts Increasing
Outcomes-based contracts most common in cardiovascular disease, infectious disease, and oncology.
Strategic Imperatives for Skilled Nursing Facilities Preparing for New Payment System
In August 2018, CMS is expected to finalize a proposed new payment methodology for skilled nursing facilities (SNFs) that would shift the focus from resource use to patients’ clinical needs.
More than 1 in 5 Medicare Cancer Patients Receive Care from Oncology Care Model Doctors
More than 25% of patients with breast and lung cancers have been treated by a participating Oncology Care Model doctor. Participation trends could accelerate the transformation of treatment for some cancers, according to Avalere experts.
Readmission Rates Are 6 Times Higher for Some Conditions in Medicare’s New Bundled Payment Program
As the deadline approaches for providers to make decisions on their participation in BPCI Advanced, Avalere analysis shows that certain conditions may provide greater opportunity for success.
CMS Takes Steps to Advance the “Meaningful Measures” Initiative
CMS removes 25 existing hospital quality measures in the Proposed FY2019 Inpatient Prospective Payment System (IPPS) Rule as part of its broader effort to focus on measures that matter.
The Future of the Center for Medicare & Medicaid Innovation
On April 24, 2018, Avalere experts were joined by Aledade CEO, Farzad Mostashari, MD, to discuss the latest developments coming out of the Center for Medicare & Medicaid Innovation (CMMI).
Webinar: The Future of CMMI: Where Do We Go from Here?
Avalere experts are joined by Aledade CEO, Farzad Mostashari, MD, discussing the latest developments coming out of the Center for Medicare & Medicaid Innovation (CMMI).
Financial Results of MSSP and CMMI Demos Are Mixed
MSSP and CMMI demonstrations vary in budgetary impact but generally show quality improvement.
Registries Continue to Give More Opportunities for Clinicians to Meet Reporting Requirements
The number of CMS-approved Qualified Clinical Data Registries grew by 40% in 2018, allowing specialties to have more opportunities to report on meaningful quality measures.
Medicare ACOs Have Increased Federal Spending Contrary to Projections That They Would Produce Net Savings
Incentive payments in upside-only Medicare ACOs have increased federal costs, but data suggest that ACO experience and adoption of two-sided risk could constrain future Medicare costs.
BPCI Advanced Provides a Glimpse into the Future of Bundled Payments
Last month, the Centers for Medicare & Medicaid Services (CMS) released a Request for Application (RFA) for the Bundled Payment for Care Improvement (BPCI) Advanced initiative.
BPCI Advanced: What Hospitals and Physicians Need to Know
With applications for the new Bundled Payment for Care Improvement (BPCI) Advanced initiative due on March 12, providers have a short window to act.
Medicare Financial Incentives Encourage Providers to Take on Greater Financial Risk
While clinicians have been hesitant to assume risk, bonus payments would result in 9 out of 10 ACOs and their participants achieving a net positive financial impact.
Our Take on the BPCI Request for Application Announcement
The Centers for Medicare & Medicaid Services (CMS) have released a Request for Application (RFA) for the Bundled Payments for Care Improvement (BPCI) Advanced Initiative.
Emerging Trends for Market Access Planning in 2018
Market access teams should consider 3 growing trends in their 2018 strategic planning.