NY Rural Providers Turn Medical Homes into an ACO
What makes this medical home project different from many others around the country is that it is an all-payer pilot. After lengthy negotiations between providers and payers, the health plans agreed to pay the medical homes $7 per member per month to care for some 100,000 patients during the first year.
Accounting for Non-Performance-Related Variation in Shared Savings Contracts
Variation between targeted and actual PMPM costs can be due to numerous factors, including many that have nothing to do with the quality or cost of care provided to ACO members.
Six Ways to Address Non-Performance-Related Variation in ACO Contracts
While not yet a perfect science, payers and providers can begin to address non-performance-related variation in a number of ways.
Value-Based Reimbursement Resource
This too contains useful information on CMS's Value-Based Purchasing Program and other initiatives that will help improve the quality of care in hospitals.
Fact Sheet: Standards for Consumer Assistance Programs for Healthcare Insurance Exchanges
This fact sheet provides details of CMS's rule outlining training requirements applicable to assistance personnel in healthcare insurance exchanges mandated under the Affordable Care Act.
At a Glance: What the Final Health Insurance Exchange Navigator Rule Means for Providers
Can hospitals and health systems serve as navigators or other assisters for the health insurance marketplaces? Here’s what the CMS final rule has to say.
Medicaid Healthcare-Acquired Condition Fact Sheet
This document discusses noteworthy aspects of the final rule prohibiting payments to states for the treatment of healthcare-acquired conditions, and authorizes states to identify other preventable conditions for which Medicaid payment will be prohibited.
Hospital Inpatient Value-Based Purchasing Program Final Rule Fact Sheet
CMS published a final rule to implement a new hospital value-based purchasing program under which hospitals that meet or exceed certain quality measures relating to clinical process of care and patient experience of care would be rewarded incenctives beginning in FY13.
Bundled Payments for Care Improvement Initiative Fact Sheet
CMS announces its request for applications for providers to test episode-based payment for care using bundled payment methods under the Bundled Payment for Care Improvement initiative.
ACO Final Rule
The full text of the ACO Final Rule.