As Chief Medical Officer of NextGen HealthCare, Betty Rabinowitz, MD, FACP's role is to promote and improve NextGen's solutions in support of provider performance, clinical outcomes, patient satisfaction, and financial efficiency. In this episode of Value Based Care Insights, host Daniel J. Marino, Principal Partner at Lumina Health Partners, and Betty discuss to how create the right incentives under risk-based contracts and how organizations can achieve the right amount of success in a value-based care environment.
The Centers for Medicare & Medicaid Services (CMS) recently announced the ACOs that will be participating in the Medicare Shared Savings Program (MSSP) as of July 1, 2019, including those participating in the new Pathways to Success structure. According to the National Association of ACOs (NAACOS), of the 518 MSSP ACOs in 2019: About 40 ...Read More
Join us as Daniel Marino, MBA, MHA, Managing Partner for Lumina Health Partners, and Maha Salah-Uh-Din, MPH, Senior Advisor for Lightbeam Health Solutions, present the top three strategies for building a proven blueprint for success under CMS’s ACO Pathways to Success program. Once organizations decide to participate in the program, executing on the right actions ...Read More
Although the healthcare trend is shifting risk to providers, health plans have important roles to ensure both parties succeed. Although provider risk needs include a blueprint to prepare and engage in risk-based contracts, health plans can help determine success by sharing knowledge and insight with them, said Meredith Duncan, executive director and COO of Aetna’s ...Read More
I’m excited to announce that I will be giving two presentations at HFMA’s 2019 Annual Conference on June 23-26 in Orlando. These two sessions focus on important areas that assist organizations as they transition into value-based care: On Sunday, June 23 from 12:30 p.m. to 3:30 p.m., I will present “Building the Blueprint to Support ...Read More
Managing Partner Daniel Marino will present “How to Build a ‘Risk-Ready’ Healthcare Organization” on Jan. 14, 2020 from 12:45 to 1:45 p.m. at HFMA’s Western Symposium at the Paris Hotel & Casino in Las Vegas, Nevada. Learn more and register here.
In the past few years, a growing number of physicians have taken leadership roles in hospitals and health systems. Given that value-based care is a team sport, this is a positive trend. Yet conflict between physicians and finance executives can arise because of their respective knowledge gaps and differing perspectives and work styles. To work ...Read More
Many eligible healthcare organizations are still determining if they plan to enter the Centers for Medicare and Medicaid Services’ (CMS’s) Pathways to Success Medicare Shared Savings Program (MSSP) for Jan. 1, 2020. As previously noted, the Notice of Intent to Apply (NOIA) can be submitted between June 1 and June 28, 2019, with the final ...Read More
The decision about whether to participate in the Centers for Medicare and Medicaid Services’ (CMS’s) new Medicare Shared Savings Program (MSSP), Pathways to Success, is complicated. It requires a detailed understanding of the rules of the program, your patient population, as well as your level of maturity with several key population-management capabilities (e.g., care management, ...Read More
The U.S. healthcare system is steadily transitioning from fee-for-service (FFS) reimbursement to fee-for-value (FFV) payment. This change has already started to affect medical practice revenue, and it will have an even bigger impact in the years ahead. Unfortunately, most physicians and practice managers understand only part of the FFV equation. While they know the quality ...Read More
Nearly every aspect of the healthcare world is changing―constantly, unpredictably, and quickly. As stakeholders navigate their various paths, knowing what to expect can help with decision making about compliance, risk, cost, and more. We have identified 7 areas that healthcare leaders must navigate to stay ahead of change and remain agile, effective, and profitable. 1. ...Read More
Facing growing pressure from insurers to assume more financial risk, healthcare providers are exploring ways to better manage cost and utilization through risk-based contracts. Unfortunately, the approaches these organizations have adopted are too often inadequate, because their executive teams are giving most of their attention to the contract itself and not enough thought to what ...Read More