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Are You Self-Sabotaging Your Practice’s VBP Performance?

June 13, 2024

Over the course of the past decade, as more practices have entered the arena of Value-Based Care, practice operational functions have increasingly become an after-thought. The promise of big bonus checks (real or imagined) has created an environment in which small and mid-sized practices have shifted their focus toward RAF, gap closure activity, quality indicator […]

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Key Considerations for AHEAD Version 2.0

June 11, 2024

As we write to you in June 2024, the first cohort application dates have passed and the third in August remains. Our team highlights key considerations for hospitals below: 1. Hospitals Should Monitor Whether Their State Applied for Cohorts 1 & 2 or Intend to Apply for Cohort 3: Applications for the first two […]

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Driving Value with Analytics in CalAIM

May 23, 2024

As CalAIM continues through year three of implementation, Enhanced Care Management (ECM), Community Health Workers (CHWs) and Community Supports (CS) continue to scale. These services are increasing integration with primary care provider organizations, whether an in-house service, contracted or a referral partner, who are ultimately accountable to managed care plans (MCPs) and the State for […]

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FQHC New Access Points: What to Know if Your Organization is Considering Applying

May 23, 2024

Background: Federally Qualified Health Centers (FQHCs) are designated entities in the national Health Center Program that are instrumental in providing healthcare services to underserved communities and increasing access to high quality, affordable healthcare. The fee for service model does not reimburse most providers at an adequate level to be sustainable with the growing Medicaid […]

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4 Ways Community Health Workers Impact Primary Care Clinic Performance

May 23, 2024

Community Health Workers (CHWs), also referred to as Promotores, are community-based frontline health workers experienced in providing linguistic and culturally sensitive, individualized whole person care in both clinical and non-clinical environments. CHWs can enhance access to and quality of primary care and are often underutilized due to a lack of understanding of their capabilities and […]

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The Importance of Integrated Claims and Electronic Medical Record Data for a Successful Value-Based Contract

April 11, 2024

Value-based contracts offer provider organizations an opportunity to govern themselves in order to provide high-quality, cost-efficient care to their attributed members and take responsibility for determining the most efficient and effective use of healthcare resources. Much has been written on what a value-based contract is, what is included in a value-based contract, how to negotiate […]

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Investing in NPs/PAs to Improve Primary Care Provider Shortages

April 11, 2024

At the end of February, the Millbank Memorial Fund released their 2024 primary care scorecard entitled ‘No One Can See You Now’. A bleak assessment of primary care in the United States, the scorecard identifies five key contributors to the ever-worsening patient access crisis, the top two of which cite the need for workforce expansion1: […]

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What You Need to Know About CMS’ New ACO Primary Care Flex Model

April 1, 2024

Recently we shared key considerations for organizations considering or planning to apply to the Medicare Shared Savings Program (MSSP), 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 by creating Accountable Care Organizations (ACOs). […]

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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 […]

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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 […]

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