If you run a Value-Based Care Organization, take our 3-minute self-assessment

Blog

The MSSP ACO Application is Approaching: Are You Preparing Accordingly?

March 19, 2024

The Medicare Shared Savings Program (MSSP) is a progressive risk sharing program created as part of the Affordable Care Act in 2010 that enables physician networks to take risk against a budget and share in potential savings. Within the program, physicians create Accountable Care Organizations (ACOs) to cover a Medicare Fee for Service (FFS) population […]

Read more

Webinar: Strategies to Optimize Medicaid Quality & Revenue

March 6, 2024

As Medicaid populations are increasing and Medicaid managed care contracting requirements are trending to more rigorous quality requirements, health systems must develop strategies to improve quality while managing losses that clinics serving mostly Medicaid typically experience. Speakers: • Steven Carson, MHA, BSN, RN, Senior Vice President, Population Health, Temple University Health • Stephanie King, Assistant […]

Read more

Key Considerations for AHEAD

February 29, 2024

Background: In September 2023, the CMS released the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. At that time, we shared with you five key initial considerations. With the recent release of Version 1.0 of CMS’ Medicare Fee-for-Service (FFS) global budget methodology our team has put together some updated considerations for health […]

Read more

New York State 1115 Medicaid Waiver Amendment: Social Care Networks

February 29, 2024

One of the main initiatives in New York’s just under $7.5 billion 1115 Medicaid waiver amendment is the formation of 13 regionally based Social Care Networks (SCN) that will be responsible for building, maintaining and strengthening networks of Community-Based Organizations (CBO) to deliver health-related social needs (HRSN) services. The Request for Application (RFA) window to […]

Read more

Strategies to Optimize Medicaid Quality and Revenue

February 29, 2024

Medicaid membership has grown dramatically over the past decade, even with the recent dips due to fall-off from post Public Health Emergency redetermination, however Medicaid reimbursement has not kept up with inflation. Health systems and other providers are in a very tight spot with increasing costs driven by staffing, supply chain, the need to transform […]

Read more

ACO REACH: Selecting the Right Track and Risk Profile is Not Easy

January 30, 2024

A year ago, we explored the first results of the Global & Professional Direct Contracting (GPDC) program¹ (renamed to ACO REACH for performance year 2023) and found four themes:  Most participants could have earned greater savings by selecting a different risk arrangement (Professional or Global); “New Entrant” REACH ACOs tended to earn larger savings than […]

Read more

5 Things to Know About Community Health Workers

January 30, 2024

Community Health Workers (CHWs), also known as Promotores, are community-based professionals who provide culturally competent, person-centered support. CHWs provide a range of services for vulnerable populations to close gaps in care and navigate resources to help members better self-manage their health and social needs. In September 2022, the Biden Administration announced it was awarding $225 […]

Read more

Medicaid Global Budgets for Downstate New York Safety Net Hospitals

January 24, 2024

On January 9, 2024, CMS approved an amendment to New York’s Medicaid 1115 Waiver, allowing the state to make investments in Medicaid initiatives that expand access to primary and behavioral health, address health-related social needs (HRSN) to reduce disparities and promote health equity, and strengthen the healthcare workforce. The term of the demonstration amendment will […]

Read more

What to Expect in 2024 for Healthcare

January 18, 2024

Greetings health care colleagues: Well, we’re through the Yuletide season and most folks are back from holiday travels or hibernations. It’s 2024 and an election year. What can we expect to see this year and for those of us updating strategic plans and reviewing our priority initiatives what should we be considering? 1. Significant ongoing […]

Read more

Webinar: Building a Successful Strategy to Embrace New Advanced Practice Providers

January 18, 2024

In this insightful webinar, speakers delve into the transformative power of Nurse Practitioner/Physician Assistant new hire, post graduate training programs in preparing healthcare providers for unparalleled success. Discover how these programs serve as a solution, addressing critical challenges faced by healthcare organizations, including workforce shortages and physician burnout.   

Read more