Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Accountable Care Organizations

How CMS Could Boost Operation of Accountable Care Organizations

by Vera Gruessner

Accountable care organizations (ACOs) have become a more mainstream method for improving care coordination and the quality of medical services while providing an opportunity for reducing wasteful spending. For instance, St. John Health System’s...

Affordable Care Act Kindles Employer Narrow Network Plans

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought major reforms and deviations for the health insurance industry as well as hospitals and clinics. Along with the healthcare field, consumers and the patient community has been affected...

Aetna, Mount Sinai Invest in Accountable Care Organizations

by Vera Gruessner

Since the Affordable Care Act was passed and the Center for Medicare & Medicaid Service Innovation established the Medicare Shared Savings Program, the development of accountable care organizations began to blossom quickly. Along with CMS,...

‘The Future is Accountable Care,’ Population Health Management

by Vera Gruessner

Effective population health management remains a key aspect of running a successful accountable care network. As part of a stronger population health management program, the primary care physician’s referral system must be efficient in...

5 Elements Essential for Value-based Care Reimbursement

by Vera Gruessner

The health insurance industry has been undergoing significant changes ever since the Patient Protection and Affordable Care Act became law and rising healthcare spending brought a need for payment reform. More payers have been targeting value-based...

Healthcare Spending on Brand Name Drugs Grew 8% in 2014

by Vera Gruessner

Healthcare spending for the average insured consumer does not seem to be decreasing or even stabilizing, finds a report from the Health Care Cost Institute (HCCI). In fact, healthcare spending among insured individuals living in the United States...

Value-based Care Reimbursement Makes Strides in Health Plans

by Vera Gruessner

The fee-for-service payment model is slowly becoming an antiquated concept as more insurers and healthcare providers adopt value-based care reimbursement. Karen Ignani, President of Emblem Health and former CEO of America’s Health Insurance...

Payers Continue Favoring Accountable Care Organizations

by Vera Gruessner

As the health payer industry and the Centers for Medicare & Medicaid Services (CMS) continues to invest in value-based care reimbursement and tie payment to quality performance measurement, the benefits of accountable care organizations continues...

Hospitals Lagging Behind in Population Health Management

by Vera Gruessner

As most health payers know, population health management and value-based care payments go hand-in-hand. When it comes to effective population health management, data storage and analysis plays an integral role among payers and providers. As payers...

Payers and CMS Seek to Join Accountable Care Organizations

by Vera Gruessner

Healthcare payers seeking to reduce costs of medical services would benefit from partnering with accountable care organizations, which essentially seek high quality care in value-based payment arrangements. With a stronger focus on population...

CMS Released Proposed Rule for Accountable Care Organizations

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would revise the formula used to analyze the performance of accountable care organizations participating in the Medicare Shared Savings Program....

Physician Leadership Key to Accountable Care Organizations

by Vera Gruessner

The world of accountable care continues to draw interest from healthcare providers and payers alike. Last month, the Centers for Medicare & Medicaid Services (CMS) announced the introduction of 121 new accountable care organizations to...

Payers, Providers Use Population Health Management to Cut Costs

by Vera Gruessner

Health payers and providers of today are working more closely together to develop effective care management strategies meant to reduce medical costs, improve quality of care, and ensure better patient health outcomes. For example, more private...

How ACO Providers Could Integrate Specialty Care with PCPs

by Vera Gruessner

Healthcare providers and payers working together to develop an effective accountable care organization (ACO) and a strong contract will need to consider the importance of including specialty care, an article from the Health Affairs publication...

Accountable Care Organizations’ Rise in Quality a ‘Home Run’

by Vera Gruessner

Recently, the Centers for Medicare & Medicaid Services (CMS) announced that there will be 121 new accountable care organizations participating in the Medicare Shared Savings Program and the Next Generation ACO Model. This means that the ACO...

CMS Announced 121 New Accountable Care Organizations

by Vera Gruessner

On Monday, the Centers for Medicare & Medicaid Services (CMS) revealed that there will be 121 new accountable care organizations joining the ranks of Medicare ACOs and the Shared Savings Program. A press release from the Department of Health...

Top Challenges of Alternative Payment Models, Bundled Payments

by Vera Gruessner

The Center for American Progress released a report last Spring that tracks the progress and success of alternative payment models within the Medicare program. The report outlines that a one-size-fits-all strategy is not the right one to take...

Population Health, Risk-sharing Vital for Accountable Care

by Vera Gruessner

Accountable Care Organizations (ACOs) were established in order to strengthen care coordination among a multitude of medical facilities, improve population health management, and stabilize rising healthcare costs. Through the Medicare Shared...

The Impact of Medicare Advantage Plans, ACOs, Payment Reform

by Vera Gruessner

Now that the New Year is upon us, the Medicare program may be undergoing some significant changes that could affect patients and healthcare services. One ongoing transformative characteristic is the rise in enrollment in Medicare Advantage plans....

Small Steps for Accountable Care Organizations to Boost Quality

by Vera Gruessner

While the Medicare Shared Savings Program and the Pioneer Accountable Care Organizations (ACOs) are relatively new programs for the Centers for Medicare & Medicaid Services (CMS), various results show that these models of care have not brought...

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