Medicare Data Reveal Actionable Quality–Cost Gaps in Care for Elders with Disability

CareJourney and Altarum have partnered in developing a breakthrough approach in measuring care for patients with physical and cognitive disabilities, focusing on adults aged 65 and older. In our analysis of 2018 medicare FFS claims data, we identified 6.7 million traditional Medicare patients who required long-term services and supports (LTSS) and had assessments that document these conditions. [...]

2021-01-20T10:23:13-05:00

Is the CMS Geographic Direct Contracting Model Right For You?

On December 3, 2020, Centers for Medicare & Medicaid Services (CMS) officially announced the release of the Geographic Direct Contracting Model (Geo), a highly anticipated option introduced at the outset of the Direct Contracting program, but subject to additional requests for information. We share industry enthusiasm for the model and appreciate the detailed approach on alignment and clarification on additional benefits. [...]

2021-01-06T10:34:37-05:00

Opioid Epidemic, Part 2: The Pharmacy Impact

The US Opioid Crisis Continues to Grow. In our previous blog Opioid Epidemic, Part 1: The Prevalence of Opioid Use Disorder and Impact of Distressed Communities, we utilized Medicare Part D data (over 40 million enrolled beneficiaries) to highlight the growing prevalence rates across the board in the U.S. In short, the key findings were [...]

2020-10-29T17:30:53-04:00

The Future of Value-Based Oncology: Oncology Care First (OCF)

The Centers for Medicare and Medicaid Services’ (CMS) recent COVID-19 changes to it’s Alternative Payment Models (APMs) present an opportunity for the oncology community. With the changes, CMS has given Oncology Care Model (OCM) practices the opportunity to “forgo upside and downside risk for performance periods” during the pandemic, to remove COVID-19 related episodes, and to elect into aggregate quality measures. [...]

2020-11-02T19:16:52-05:00

Understanding the Direct Contracting (DC) Payment Model

Earlier this year, the Center for Medicare and Medicaid (CMS) announced five new payment models designed to transform primary care by paying providers for outcomes rather than services. Direct Contracting and Primary Care First are two of these models announced by CMS to help encourage providers […]

2020-11-03T09:40:19-05:00
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