Blog

The Center for Medicare and Medicaid Innovation (CMMI) has announced the 51 Direct Contracting Entities (DCEs) selected to participate in the initial 2021 Implementation Period (IP) for the Direct Contracting Model Global and Professional Options. The IP began on October 1, 2020, and will run through March 31, 2021. The first Performance Year (PY) begins […]

As votes trickle in, the potential for a Biden Administration in 2021 creates numerous implications for both payers and providers. Going into the weekend and next week, what are the key considerations with relation to the strategic impacts and opportunities from a potential Biden/Harris win? First, a dose of reality: Hopes for compromise agenda:: […]

In COPE Health Solutions‘ first virtual panel, we discuss with leading experts how health plans are responding to the Covid-19 crisis. Our panelists shared how health plans are pivoting their short and long-term strategies, using data analytics, preparing for the upcoming contracting year, and more. 

Program Structure and Features CMS launched Medicare Direct Contracting (MDC) in 2019, giving providers and payers an opportunity to take risk and manage population health for Medicare fee-for-service (FFS) beneficiaries. Although the program builds on existing features of accountable care organization (ACO) models, payments under MDC will be based on partial or full capitation. To […]

The Covid-19 pandemic has spurred rapid implementation of virtual health across the country. Many providers quickly launched telehealth and remote patient monitoring to free up capacity for Covid-19 surges, manage their chronic and high-risk patients from the safety of their homes, and provide an alternative means to access care for those patients fearful or unable […]

Take a look at how the CHART Model compares with other CMS accountable care programs, such as Medicare Direct Contracting, NextGen ACO, and Shared Savings.

CMS CHART Model Fact SheetIn August 2020, the Centers for Medicare & Medicaid Services (CMS) announced Community Access and Rural Transformation (CHART) Model. This model is designed to support rural communities and providers in improving quality and access to care, while providing financial stability and upfront payments to support the transition to value-based payment models. […]

In early August 2020, the Centers for Medicare and Medicaid Services (CMS) announced the Community Health Access and Rural Transformation (CHART) Model. This model aligns well with the overall momentum toward value-based payment from CMS, states, employers and health plans that has grown incrementally for several years. This particular program is targeted at reducing disparities […]

Hospitals and health systems across the country are grappling with the financial impact of Covid-19. One critical strategy to combat lost revenue is to reduce out-of-network leakage. Understanding in real time where the leakage is occurring and developing strategies to bring the patients back into your own network can increase revenue, close quality care gaps, […]

Introduction Since March of 2020, the entire health care system supply chain has been disrupted due to the impact of the Covid-19 pandemic. Stay-at-home orders, unemployment and a surge of Covid-19 patients suppressed outpatient volumes, acutely altered payer mix and constrained hospital capacity. Fee-for-service (FFS) primary care was hit especially hard by this seismic shift […]