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. [...]
Blue Button 2.0: Everything You Need to Know and More! Joe Mercado Request Meeting Overview & Brief History of [...]
For countless individuals across the United States and the world, the outbreak of the COVID-19 pandemic prompted a rapid shift to digital life. In the healthcare industry, the sudden need to reduce patient travel and exposure while preserving provider capacity resulted in an unprecedented increase in the adoption of telemedicine. [...]
Although research has shown that a person’s health outcome is closely related to the social and environmental backgrounds they live and interact with, questions around how social factors impact health outcomes have never received copious attention until the country was struck by the COVID-19 pandemic. [...]
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 [...]
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. [...]
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 […]
Kidney Care Choices (KCC) is a voluntary alternative payment model built on top of the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) model structure. The goal of the KCC model is to encourage nephrologists, dialysis facilities, and ESRD healthcare practices to [...]
According to the American Heart Association, more than 1.5 million people in the United States experience a heart attack or stroke each year, with heart disease and stroke consistently among the top causes of death and disability. This costs the US healthcare system over $350 billion annually. [...]
In a post COVID-19 world, it’s more critical than ever for health plans to gain market share as well as decrease costs associated with poor outcomes. By achieving the 5 star rating in the Star Rating Program, Medicare Advantage prescription drug plans and stand-alone prescription drug plans are able to enroll members throughout the calendar year compared to those plans who are only allowed to enroll members through open enrollment. [...]