By the end of this week, CMS will ship refreshed baseline data to all participants in the Bundled Payments for Care Improvement Advanced (BPCI-A) program. The decisions that Hospital and Physician Group Practice (PGP) participants must make by mid-December have broad implications, especially as mandatory bundles from CMS become more [...]
Clarify Health recently hosted a virtual roundtable with industry thought leaders to get the health plan perspective on value-based contracting in a COVID-19 era. Vijay Venkatesan, Vice President and Chief Analytics Officer, Horizon Blue Cross Blue Shield of New Jersey, Stephen Carrier, Senior Vice President, Network and Provider Partnerships, Blue [...]
In December 2019, CMS released the long-awaited details on its Direct Contracting program, the most advanced risk-sharing arrangement to-date. Below is an overview of Direct Contracting, the program's rationale, challenges, and what it means for the market. 1. What is Direct Contracting? CMS’ most advanced risk-sharing program yet. ACOs [...]
After months of waiting, the Center for Medicare & Medicaid Innovation (CMMI) released details on the Direct Contracting Payment model options on Monday via a Request for Application. The 100-page document tells us many details about the model but leaves several key questions unanswered. Below, we share a summary and first reactions. We’ll be [...]
With a refreshed menu of Medicare payment models, CMS has now directly answered the question that’s been on the collective minds of all ACOs (and vendors) for a couple of years: What will be the way of the future in population health? CMS overhauled the Medicare Shared Savings Program in [...]