A Call to Action: Creating Accountable Care Organizations Answerable to Underserved and Vulnerable Populations. The Drive to Create Access & Quality
|
|
|
- Godwin Robertson
- 8 years ago
- Views:
Transcription
1 A Call to Action: Creating Accountable Care Organizations Answerable to Underserved and Vulnerable Populations The Drive to Create Access & Quality Dennis Heaphy, Disability Policy Consortium, and Ellen Breslin, EBD Consulting A DAAHR Event, April 1,
2 Today s Conversation What are ACOs? Opportunities and Risks? MassHealth and ACOs Other States (Colorado, Minnesota, and New York) Consumer Engagement and Agenda DAAHR Questions 2
3 The ACO Train Has Left the Station! Key component of the Affordable Care Act Massachusetts law cost containment (Chapter 224) Division of Insurance promulgating new regulations about financial solvency Massachusetts Health Policy Commission developing certification requirements MassHealth under financial and political pressures for rapid change MassHealth Stakeholder meeting on April 6,
4 What is an ACO? New type of healthcare organization Providers (hospitals, doctors, etc ) come together to provide care to a population ACOs accept collective responsibility for health care costs, quality and outcomes May involve multiple payers, which may introduce inequities and conflicting incentives Goal: to create a more effective and efficient healthcare delivery, through financial alignment of incentives 4
5 Are ACOs Different from HMOs? Time will tell Consideration HMO ACO Provider role Payment and Quality Financial risk Data Providers are gatekeepers restricting care Payment not tied to quality Financial risk through capitation Poor data collection or analysis Providers or facilitators of care with correct incentives Payment tied to outcomes and quality Financial risk, methods can vary: shared savings, upside only, upside and downside risk, global budgets Emphasis placed on data collection, analysis and sharing 5
6 ACOs Provide Opportunity to Create Real Reform Improve quality of care and coordination Address social determinants of health Reduce inequities in health care access and outcomes for underserved populations and people with disabilities/chronic conditions Measure quality of long-term services and supports and impact on social determinants of health using appropriate quality metrics Improve data collection and sharing, accountable to the consumer and the public 6
7 ACOs Raise Many Questions and Risks What happens to consumer choice? Will ACOs avoid persons with high needs? What does the financing look like? Are payments and incentives linked directly to the right providers and to the right outcomes? Will large hospitals dominate the ACO market? Will vital community based organizations be included or excluded? What happens to provider autonomy? Can we expect preferred referral lists? Will some populations have longer waits? 7
8 MassHealth MassHealth faces many financial pressures SFY 2016 budget $15.2 billion for 1.8 million lives High inpatient, high ED, does not qualify as good care MassHealth has great programs, but great programs do not guarantee great outcomes Care coordination and integration (MCO, PCC Plan, SCO, PACE, One Care) PCPR (global payment for primary care, shared savings for non primary care) How can MassHealth address the social needs better? 8
9 What Do MassHealth Members Need? MassHealth members need more than health care. They need social services, housing, nutritional assistance, transportation and employment assistance. We know that health outcomes are driven by the social determinants. 10% medical care, 20% human biology, 20% environment, 50% lifestyle and behavior. This is not new information, so what is the problem? There is currently no good way to compensate providers for the social determinants. We should be paying providers more to take on the challenges related to poverty. We need to involve new partners, new providers, community based organizations. 9
10 Can Medicaid ACOs Address Social Needs? Yes. Many states are trying to address poverty related issues through Medicaid ACOs. Examples: - Colorado s Regional Care Collaborative Organizations (RCCOs) refer members to non medical supports. - Minnesota requires its Integrated Health Partnerships (IHPs) to contract with community based organizations and social services agencies. - New York s Delivery System Reform Incentive Payment (DSRIP) program supports community based integration through its Performing Provider Systems (PPSs). - Massachusetts is taking a look at many of these models. It has mentioned NY recently. 10
11 New York s Delivery System Reform Incentive Program (DSRIP) NY received a waiver from CMS to spend $6.8 billion over the next 5 years. Key Point #1. Transformation Involves Reductions in Hospital Use. The goal of this reform is to transform the delivery and payment system. Desired outcome is to reduce hospital use by 25% over 5 years. Winners and Losers. Key Point #2. Significant Funds for Performing Provider Systems (PPPs). Multiple partners, will earn funds based on their successful implementation of the projects. 95% of funds must go to safety nets. Funds for revenue loss, investment and bonus payments. This could shortchange community based organizations. Key Point #3. Payments Linked to Successful Achievement of Numerous Measures. Projects vary in focus: system transformation, clinical outcomes, population health. Measures are fairly typical. 11
12 Consumer Engagement How Do We Take Advantage of this Opportunity? Involvement at every stage of ACO development and implementation. Receive equal status at all ACO meetings in state planning processes, not limited to stakeholder meetings. Achieve measurable results including ACO requirements. Assume impactful roles on ACO governing bodies. 12
13 List of Questions for Advocates to Answer What should ACO governance structure look like? How should ACOs be financed to improve consumer access to all services needed? What should be done to protect the rights of underserved and high-risk people in ACO assignment? What best practices should ACOs put in place to deliver better quality coordinated care? How do consumers and other stakeholders hold ACOs accountable for delivering quality care? How will quality be defined to ensure ACOs meet the community service needs of enrollees? 13
14 Major Take Aways Address social determinants of health housing, nutrition, mold, safety, job training. Ensure that non medical providers and organizations receive equal respect and value for their role; these providers are vital to addressing the social determinants of health. Develop the right financing approach. Establish consumer-driven quality metrics. Require state and federal investment into infrastructure, data and reporting. 14
15 The DAAHR Experience Consumer choice and control must drive advocacy. Must have measurable community organizing and consumer engagement at the grassroots level. Collaboration with stakeholders is key. Focus on the big picture. Transparency is critical. Protect continuity of care. Quality metrics that address social determinants. Emphasize nonmedical services. Build capacity and competency of plans and their networks over time. No quick fix or auto assignment. Financing that supports each population. 15
16 Contact Us Dennis Heaphy Disability Policy Consortium Bill Henning Boston Center for Independent Living REMINDER: MassHealth Stakeholder Meeting Monday, April 6, 2015, 12:30-2:30pm 19 Staniford Street, Hurley Building, Minihan Hall (6th floor) 16
Designing Integrated Payment Systems in Medicaid
Designing Integrated Payment Systems in Medicaid Commonwealth of Massachusetts Public Payer Commission May 5, 2014 Tricia McGinnis Director of Delivery System Reform, CHCS Supported by The Massachusetts
Considerations in moving to an Accountable Care Organization Strategy for RI Medicaid
Considerations in moving to an Accountable Care Organization Strategy for RI Medicaid Executive Office of Health and Human Services Deidre Gifford, MD Medicaid Director Background Medicaid program costs
Payor Perspectives on Provider Realignment and ACOs
Payor Perspectives on Provider Realignment and ACOs Joel L. Michaels March 15, 2011 Overview Issues to be addressed Medicare Shared Savings Program overview ACO organization options Health care reform
Testimony to the Senate Committee on Veterans Affairs and Health S. B. 739. February 27, 2014. What is an Accountable Care Organization or ACO?
Testimony to the Senate Committee on Veterans Affairs and Health S. B. 739 Professor Sidney D. Watson Center for Health Law Studies Saint Louis University School of Law February 27, 2014 My name is Sidney
Minnesota s Integrated Health Partnership
Minnesota s Integrated Health Partnership Minnesota s IHP program was designed to create a shared risk arrangement to improve care coordination and quality Program applies to all Medicaid beneficiaries,
With the support of The Commonwealth Fund, NASHP is tracking state efforts to lead or participate in accountable care models that include Medicaid
1 With the support of The Commonwealth Fund, NASHP is tracking state efforts to lead or participate in accountable care models that include Medicaid and Children s Health Insurance Program populations.
Supporting Social Service Delivery through Medicaid Accountable Care Organizations: Early State Efforts
BRIEF February 2015 Supporting Social Service Delivery through Medicaid Accountable Care Organizations: Early State Efforts By Roopa Mahadevan and Rob Houston, Center for Health Care Strategies T IN BRIEF
Accountable Care Organization Overview
Accountable Care Organization Overview Presented by: Bill Wachs & Kai Tsai April 28, 2015 This webinar is brought to you by the American Hospital Association s Center for Healthcare Governance. Backed
Alternative Payment Methodology Provider Engagement Update PUBLIC PAYER COMMISSION APRIL 10, 2014
Alternative Payment Methodology Provider Engagement Update PUBLIC PAYER COMMISSION APRIL 10, 2014 1 Who We Are Member of BMC, New England s largest DSH Statewide MA Medicaid HMO Statewide NH Medicaid MCO
Accountable Care Organizations (ACOs) Work Group. March 6, 2014
Accountable Care Organizations (ACOs) Work Group March 6, 2014 Agenda Welcome Introductions Agency Presentation Statutory Authorization for ACOs Work Group Charge Insurance Law Background Overview of Draft
Early Lessons learned from strong revenue cycle performers
Healthcare Informatics June 2012 Accountable Care Organizations Early Lessons learned from strong revenue cycle performers Healthcare Informatics Accountable Care Organizations Early Lessons learned from
Public Stakeholder Session: Payment and Care Delivery Reform
Public Stakeholder Session: Payment and Care Delivery Reform Executive Office of Health & Human Services May 22, 2015 Goals for today Review MassHealth priorities and stakeholder engagement plan Set course
Accountable Care and Value Based Payments 101: Government Programs Update
1 Accountable Care and Value Based Payments 101: Government Programs Update June 24 th, 2014 Dave Neiman, FSA, MAAA Senior Consulting Actuary DaveN@Wakely.com (720) 226-9806 2 Caveats Opinions expressed
The Affordable Care Act
The Affordable Care Act What does it mean for internists? Joshua Becker MD 10/14/2015 VII. 2015 Reforms and Beyond Payment Penalties under Medicare s Pay-for-Reporting Program Value-Based Payment Modifier
CONFLICT FREE CASE MANAGEMENT. Susan Fout October 30, 2014TE
CONFLICT FREE CASE MANAGEMENT Susan Fout TE Introduction History Targeted Case Management - Review Conflict Free Case Management Definition Policy What is the problem & Questions to consider Potential
Medicaid Accountable Care Organizations in Other States
Joint Legislative Oversight Committee on Health and Human Services Medicaid Accountable Care Organizations in Other States David Rice Fiscal Research Division February 11, 2014 Accountable Care Organizations
LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery
LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery 1 The Pioneer ACO Model James Vasquenza Jr. Vice President, Preferred Provider Network, Innovatix
Massachusetts Bulletin for People with Medicare January 2016
The Commonwealth of Massachusetts Executive Office of Elder Affairs One Ashburton Place, 5th Floor Boston, Massachusetts 02108 CHARLES D. BAKER Governor KARYN E. POLITO Lieutenant Governor Tel: (617) 727-7750
Accountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014
Accountable Care Communities 101 Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Premier is the largest healthcare alliance in the U.S. Our Mission:
Medicaid Accountable Care Organization Programs: State Profiles
BRIEF OCTOBER 2015 Medicaid Accountable Care Organization Programs: State Profiles By Jim Lloyd, Rob Houston, and Tricia McGinnis, Center for Health Care Strategies S IN BRIEF States are implementing accountable
DSRIP QUARTERLY REVIEW PROCESS: Project Requirement - Timeframe. Project Requirement - Unit Level Reporting
DSRIP QUARTERLY REVIEW PROCESS: PPSs will submit a quarterly report to the Independent Assessor throughout the DSRIP program via the automated MAPP tool which includes Domain 1 DSRIP Requirement Milestone
Health Policy Commission 1
Health Policy Commission 1 Finding: Emergency Department Utilization Health Policy Commission 2 Emergency department utilization Previous findings ED use is relatively high in Massachusetts, and varies
Value Based Care and Healthcare Reform
Value Based Care and Healthcare Reform Dimensions in Cardiac Care November, 2014 Jacqueline Matthews, RN, MS Senior Director, Quality Reporting & Reform Quality and Patient Safety Institute Cleveland Clinic
Georgia Society for Healthcare Materials Management. The status of ACO s in the market and how they impact materials management.
Georgia Society for Healthcare Materials Management The status of ACO s in the market and how they impact materials management October 25, 2013 A Highly Volatile And Complex Industry Key Trends Impacting
1115 Medicaid Waiver Programs Section1115 of the Social Security Act allows CMS the authority to approve state demonstration projects that improve care, increase efficiency, and reduce costs related to
Care Coordination among DSRIP Partners
Care Coordination among DSRIP Partners John F. Skip Williams, Jr., MD, EdD, MPH Maureen Fahey, RN, MBA Thursday, June 25, 2015 3:00-3:30 pm OVERVIEW OF PRESENTATION New York State DSRIP Overview Brooklyn
INTEGRATING HOUSING IN STATE MEDICAID POLICY
INTEGRATING HOUSING IN STATE MEDICAID POLICY April 2014 INTRODUCTION As evidence continues to establish supportive housing as an intervention that stabilizes people with chronic illnesses and/or behavioral
AHLA. Q. Medicaid ACOs: Coming to a Neighborhood Near You. Clifford E. Barnes Epstein Becker & Green PC Washington, DC
AHLA Q. Medicaid ACOs: Coming to a Neighborhood Near You Clifford E. Barnes Epstein Becker & Green PC Washington, DC Jennifer E. Gladieux Senior Health Policy Analyst Health Policy Source, Inc. Alexandria,
Redesigning the Publicly-Funded Mental Health System in Texas
Redesigning the Publicly-Funded Mental Health System in Texas Access to care when services are needed Choice in health plans for consumers and providers Integration of care at the plan and provider level
The Commonwealth of Massachusetts Executive Office of Health and Human Services One Ashburton Place, 11 th Floor Boston, MA 02108
DEVAL L. PATRICK Governor TIMOTHY P. MURRAY Lieutenant Governor The Commonwealth of Massachusetts Executive Office of Health and Human Services One Ashburton Place, 11 th Floor Boston, MA 02108 JUDYANN
Massachusetts Health Care Reform and Cancer Care. Therese Mulvey, MD Southcoast Centers for Cancer Care February 2010
Massachusetts Health Care Reform and Cancer Care Therese Mulvey, MD Southcoast Centers for Cancer Care February 2010 Southcoast Health System in Massachusetts Southcoast Primary and Secondary Markets An
How To Understand An Accountable Care Organization
Accountable Care Organizations and Wound Centers No Disclosures Peter F. Lawrence, MD Professor and Chief Division of Vascular Surgery University of California Los Angeles Accountable Care Organization
Accountable Care Organizations: What Are They and Why Should I Care?
Accountable Care Organizations: What Are They and Why Should I Care? Adrienne Green, MD Associate Chief Medical Officer, UCSF Medical Center Ami Parekh, MD, JD Med. Director, Health System Innovation,
Update on Health Reform the ACA in Ohio
Update on Health Reform the ACA in Ohio J. B. Silvers, PhD Weatherhead School of Management Case Western Reserve University jb.silvers@case.edu Note: I have no commercial or financial interests in the
Post-care Networks and LTACs: Finding Your Place in an ACO Model
Post-care Networks and LTACs: Finding Your Place in an ACO Model Accountable Care Organizations (ACOs) are more than just a fad. Post-care providers and LTACS in particular, will need to give careful thought
How To Understand Why The Health Care Act Matters
Why the Affordable Care Act Matters Mindy Owen RN, CRRN, CCM Phoenix HealthCare Assoc. LLC Coral Springs Florida Objectives The participant will be able to define the relationship between the ACA and the
Medicaid Payment and Delivery System Reforms: Minnesota s Experience
Medicaid Payment and Delivery System Reforms: Minnesota s Experience NATHAN MORACCO ASSISTANT COMMISSIONER MINNESOTA DEPARTMENT OF HUMAN SERVICES MARCH 2014 Overview A little Minnesota context Past Minnesota
Commonwealth of Kentucky Cabinet for Health and Family Services (CHFS) Office of Health Policy (OHP)
Commonwealth of Kentucky Cabinet for Health and Family Services (CHFS) Office of Health Policy (OHP) State Innovation Model (SIM) Model Design June Integrated and Coordinated Care Workgroup June 16, 2015
Financial Implications: The Push from Inpatient to Outpatient Care
Financial Implications: The Push from Inpatient to Outpatient Care Brian Baumgardner & Mitchell Mongell THE TRANSFORMATION TO CONSUMER-DRIVEN HEALTHCARE FINANCIAL IMPLICATIONS:THE PUSH FROM INPATIENT TO
Accountable Care Platform
The shift toward increased collaboration, outcome-based payment and new benefit design is transforming how we pay for health care and how health care is delivered. UnitedHealthcare is taking an industry
3M s unique solution for value-based health care
A quick guide to 3M s unique solution for value-based health care Volume-based health care Part 1: Helping your organization navigate the journey from volume- to value-based health care. Value-based health
Impact of Health Care Reform on. California Ambulance Association September 19, 2012
Impact of Health Care Reform on California s EMS System California Ambulance Association September 19, 2012 Impact of Health Care Reform on California s EMS System What is the Cost of Readiness? Patient
Value-Based Purchasing Literature Survey August 2012
Value-Based Purchasing Literature Survey August 2012 This document highlights a selection of briefs, reports, and commentaries on value-based purchasing payment reform methods as well as how payment reforms
Affordable Care Act Opportunities for the Aging Network
Affordable Care Act Opportunities for the Aging Network The Affordable Care Act (ACA) offers many opportunities for the Aging Network to be full partners in health system reform. These include demonstration
CIRCULAR LETTER NO. 2251 NOTICE OF HEARING ADJUDICATORY RULES FOR CLAIMS AND COMPLAINTS BEFORE THE DEPARTMENT OF INDUSTRIAL ACCIDENTS
January 8, 2015 CIRCULAR LETTER NO. 2251 To All Members and Subscribers of the WCRIBMA: NOTICE OF HEARING ADJUDICATORY RULES FOR CLAIMS AND COMPLAINTS BEFORE THE DEPARTMENT OF INDUSTRIAL ACCIDENTS Attached
CMS Innovation Center Improving Care for Complex Patients
CMS Innovation Center Improving Care for Complex Patients ECRI Institute Dr. Patrick Conway, M.D., MSc CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality Director, Center for
Key Provisions Related to Nursing Nursing Workforce Development
Key Provisions Related to Nursing The newly released House bill, the Affordable Health Care for America Act (HR 3962), clearly represents a movement toward much-needed, comprehensive and meaningful reform
Systems in the Act, Trying Out ACOs
A L O O K A H E A D Systems in the Act, Trying Out ACOs BY MARK CRAWFORD Catholic health care leaders are experimenting with accountable care organizations (ACOs) as a method of delivering higher quality
Future of Health Care: How Do You Fit In? Physician Leadership Institute February 28, 2015 Brian M. McCook, CPA
Future of Health Care: How Do You Fit In? Physician Leadership Institute February 28, 2015 Brian M. McCook, CPA Learning Objectives Industry Transitions Challenges and Changes ACO s Look at the Future
The Importance of Shared Care Management
ACOs and Medicaid: Challenges and Opportunities March 23, 2011 Barbara Eyman Charles Luband Ropes & Gray Ropes & Gray Barbara.Eyman@ropesgray.com Charles.Luband@ropesgray.com 202.508.4762 212.596.9217
Accountable Care: Implications for Managing Health Information. Quality Healthcare Through Quality Information
Accountable Care: Implications for Managing Health Information Quality Healthcare Through Quality Information Introduction Healthcare is currently experiencing a critical shift: away from the current the
PREPARING FQHCS FOR DSRIP: DSRIP Projects. A Webinar with CohnReznick and Health Management Associates
PREPARING FQHCS FOR DSRIP: DSRIP Projects A Webinar with CohnReznick and Health Management Associates Today s Presentation DSRIP Background CHCANYS DSRIP Support for FQHCs DSRIP Projects PPS Project Selection
Accountable Care Collaborative Colorado Department of Health Care Policy and Financing
Accountable Care Collaborative Colorado Department of Health Care Policy and Financing 1 Healthcare Reform Accountable Care Organizations (ACOs) National Health Reform Accountable Care Collaborative (ACC)
Banner Health Network Pioneer ACO - Physician Toolkit
& The Banner Health Network, an AIP and Banner Health partnership, present the Banner Health Network Pioneer ACO - Physician Toolkit This BHN Pioneer ACO Physician Toolkit has been developed to provide
Allina Health System. Accountable Care thoughts from an ACO Pioneer
Allina Health System Accountable Care thoughts from an ACO Pioneer Care Integration and Payment Reform Workgroup Elmer Anderson Human Services Building St.Paul, MN February 6, 2012 Objectives for Today
ACOs: Six Things Specialty Practices Should Know
ACOs: Six Things Specialty Practices Should Know =TOS Newsletter, July/August 2014= Authors: John P. Schmitt, Ph.D. and J. Garrett Schmitt, MBA, PCMH CCE INTRODUCTION Do you remember the analogy of four
Medicare Shared Savings Program Final Rule
Healthcare Committee Medicare Shared Savings Program Final Rule On June 9, 2015, the Centers for Medicare & Medicaid Services ( CMS ) published a final rule that, according to the agency, will update and
Health Care Financing: ACC/ ACO s, beyond the hype hope. Brian Seppi, MD, President, Washington State Medical Assn.
: ACC/ ACO s, beyond the hype hope Brian Seppi, MD, President, Washington State Medical Assn. Washington State Medical Association Health Care Financing Our vision Make Washington the best place to practice
DEPARTMENT OF HEALTH AND HUMAN SERVICES
DEPARTMENT OF HEALTH AND HUMAN SERVICES The President s 2009 Budget will: Prevent and prepare the Nation for health emergencies, including pandemic influenza and bioterrorism; Prioritize the healthcare
RE: CMS 1461-P; Medicare Shared Savings Program: Accountable Care Organizations
221 MAIN STREET, SUITE 1500 SAN FRANCISCO, CA 94105 PBGH.ORG OFFICE 415.281.8660 FACSIMILE 415.520.0927 February 6, 2015 Marilyn Tavenner Administrator Centers for Medicare and Medicaid Services 7500 Security
Health Care Reform Update January 2012 MG76120 0212 LILLY USA, LLC. ALL RIGHTS RESERVED
Health Care Reform Update January 2012 Disclaimer This presentation is for educational purposes only. It is not a complete analysis of the material contained herein. Before taking any action on the issues
11/24/2014. Current Trends in Healthcare Reform. Maximizing Value for Consumers. Provider Reimbursement Models
David R. Swann, MA, LCAS, CCS, LPC, NCC e Council for Behavioral Healthcare 2014 David Swann, MA, LCAS, CCS, LPC, NCC Senior Healthcare Consultant MTM Services Mike Forrester, PhD Chief Clinical Officer
Strategies for Success in the CMS Medicare Advantage Star Quality Ratings
Strategies for Success in the CMS Medicare Advantage Star Quality Ratings The National Pay for Performance Summit February 20, 2013, San Francisco, CA Theresa C. Carnegie Mintz, Levin, Cohn, Ferris, Glovsky
The Promise of Regional Data Aggregation
The Promise of Regional Data Aggregation Lessons Learned by the Robert Wood Johnson Foundation s National Program Office for Aligning Forces for Quality 1 Background Measuring and reporting the quality
State Innovation Models Initiative:
Department of Health & Human Services Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE Contact: CMS Media Relations
Service Inventory of Managed Care Entities to Support Development of a Health Homes State Plan Amendment
Service Inventory of Managed Care Entities to Support Development of a Health Homes State Plan Amendment March 2012 MassHealth Managed Care Entities (MCO, SCO, PACE) Health Homes Inventory to Support State
Population Health Refocusing Health Care
Population Health Refocusing Health Care The Population, The Payment, The Quality Karen Hacker, MD MPH Director, Allegheny County Health Department The Context of Health Care in the USA: A Time for Alignment
Concept Paper: Texas Nursing Facility Transformation Program
QAPI Version Concept Paper: Texas Nursing Facility Transformation Program Introduction This concept paper presents a proposal to establish a Nursing Facility (NF) Transformation Program beginning in DY
Medicaid Payment Reform
Medicaid Payment Reform Taking Center Stage in Washington & State Capitols April 29, 2011 www.chcs.org Medicaid Payment Reform: Taking Center Stage In Washington DC Federal law CMS The Affordable Care
State Oversight of ACOs
State Oversight of ACOs Bill Barcellona, VP FSSB Meeting May 19, 2011 California Association of Physician Groups What are the potential goals of state oversight? Provide an incentive to organize a fragmented
Important Information About MassHealth Coverage Changes Effective January 1
Commonwealth of Massachusetts Executive Office of Health and Human Services Important Information About MassHealth Coverage Changes Effective January 1 January is a time of great change for healthcare
ACA Strategy. Why ACOs? 4/16/2014 ACCOUNTABLE CARE ORGANIZATIONS UNDER THE AFFORDABLE CARE ACT
ACCOUNTABLE CARE ORGANIZATIONS UNDER THE AFFORDABLE CARE ACT Stephen P. Williams, JD 864 350 5276 1984carrera@gmail.com ACA Strategy One of the main ways the Affordable Care Act seeks to reduce health
Massachusetts Health Connector logo. What Does National Health Care Reform Mean for You?
Massachusetts Health Connector logo What Does National Health Care Reform Mean for You? 1 National health care reform offers more opportunities for individuals, families, and small businesses to save on
IxInsights February 2008
IxInsights #33 February 19, 2008 IxInsights February 2008 Pay-for-Performance... and Beyond: Using Incentives to Accelerate Ix Speakers: Dennis White, Senior Vice President, National Business Coalition
Mar. 31, 2011 (202) 690-6145. Summary of proposed rule provisions for Accountable Care Organizations under the Medicare Shared Savings Program
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Office of Media Affairs MEDICARE FACT SHEET FOR IMMEDIATE RELEASE
Is there an ACO in your Future? Massachusetts League of Community Health Centers Community Health Institute May 12, 2011
Is there an ACO in your Future? Massachusetts League of Community Health Centers Community Health Institute May 12, 2011 Are ACOs/Integrated Care Systems Here to Stay Why this time is different? Health
SYNOPSIS OF HEALTH CARE QUALITY MANAGEMENT SYSTEMS
SYNOPSIS OF HEALTH CARE QUALITY MANAGEMENT SYSTEMS Administration for Community Living CBO Learning Collaborative Webinar Presenter: Sharon R. Williams, Health Care Consultant April 2, 2014 2 QUALITY ASSURANCE:
Payment Reform in Massachusetts: Impact and Opportunities for the Health Care Workforce
Payment Reform in Massachusetts: Impact and Opportunities for the Health Care Workforce Jessica Larochelle July 9, 2014 Overview Forces driving payment and delivery system reform Overview of payment and
Premier ACO Collaboratives Driving to a Patient-Centered Health System
Premier ACO Collaboratives Driving to a Patient-Centered Health System As a nation we all must work to rein in spiraling U.S. healthcare costs, expand access, promote wellness and improve the consistency
The most significant challenge of becoming accountable is not forming an organization, it is forging one. ~ Phillip I. Roning 1
Physician Involvement in ACOs The Time is Now Julian D. ( Bo ) Bobbitt, Jr., Esq. Smith, Anderson, Blount, Dorsett, Mitchell & Jernigan, L.L.P. Raleigh, NC The most significant challenge of becoming accountable
Impact of Health Care Reform on the Future of Nutrition and Dietetics
Impact of Health Care Reform on the Future of Nutrition and Dietetics Understanding the changes to create new nutrition opportunities Pepin Andrew Tuma, JD Director, Regulatory Affairs Academy of Nutrition
Using analytics to get started with population health. The 3M 360 Encompass Health Analytics Suite
Using analytics to get started with population health The 3M 360 Encompass Health Analytics Suite The need for analytics in health care The global healthcare analytics market is expected to reach $21 billion
National Healthcare Reform: Implications for Nursing Education and Practice
National Healthcare Reform: Implications for Nursing Education and Practice UMass Graduate School of Nursing Alumni Association Program June 4, 2010 Katharine London 2 Goals for Today s Presentation Explain
Medicaid ACO Pediatric Quality Measures and Innovative Payment Models
Medicaid ACO Pediatric Quality Measures and Innovative Payment Models Select States Summer, 2015 Introduction Since the Medicaid program was implemented 50 years ago, it has undergone several evolutions
The Importance of Pay For Performance in Healthcare Transformation
Author: Mallory M. Johnson, MHA, Senior Consultant A push towards pay-for-performance The term pay-for-performance (P4P) has matured in healthcare over the last decade from concept to reality as healthcare
MassHealth Health Plan Input Session
MassHealth Health Plan Input Session June 25, 2014 Steve Somers Rob Houston Center for Health Care Strategies www.chcs.org Session Agenda ACO Overview Organizational Structure Discussion Break Scope of
TESTIMONY. on the Medicare Payment Advisory Commission s (MedPAC) June Report to the Congress
520 Eighth Avenue, North Wing, 3rd Floor New York, NY 10018 212.869.3850/Fax: 212.869.3532 TESTIMONY on the Medicare Payment Advisory Commission s (MedPAC) June Report to the Congress to the United States
Strengthening Medicare: Better Health, Better Care, Lower Costs Efforts Will Save Nearly $120 Billion for Medicare Over Five Years.
Strengthening Medicare: Better Health, Better Care, Lower Costs Efforts Will Save Nearly $120 Billion for Medicare Over Five Years Introduction The Centers for Medicare and Medicaid Services (CMS) and
HEALTHCARE REFORM CARE DELIVERY AND REIMBURSEMENT MODELS. April 10, 2014
HEALTHCARE REFORM CARE DELIVERY AND REIMBURSEMENT MODELS April 10, 2014 1 MARKETPLACE UPDATE 2 MARKETPLACE - ESSENTIAL HEALTH BENEFITS 3 MARKETPLACE - METAL LEVELS 4 WHAT IS THE HEALTH INSURANCE MARKETPLACE
E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences
Accountable Care Organizations and You E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences CEO, OSU Faculty Group Practice Chair, Department of Surgery Ohio State University
Health Information Technology (IT) Simplified
Health Information Technology (IT) Simplified A glossary of all things Health IT Accountable Care Organizations (ACO) - A group of health care providers who give coordinated care, chronic disease management,
How Do Key Stakeholders View Transparency?
How Do Key Stakeholders View Transparency? Given the clear need for transparency, and the gaps towards achieving the level needed to create full accountability to drive lower costs and improved quality
Nuts and Bolts of. Frank G. Opelka, MD FACS American College of Surgeons. Vice Chancellor for Clinical Affairs Professor of Surgery LSU New Orleans
Nuts and Bolts of Accountable Care Organizations Frank G. Opelka, MD FACS American College of Surgeons ACS Advocacy & Health Policy, Vice Chancellor for Clinical Affairs Professor of Surgery LSU New Orleans
Welcome! Medicare Advantage. Elderplan Advantage Institutional Special Needs Plan
Elderplan Advantage Institutional Special Needs Plan 1 Welcome! Goals for today: To give you an overview of Medicare Advantage Works To give you a sense of the role of ISNP in an SNF To provide a description
HEALTHCARE REFORM OCTOBER 2012
HEALTHCARE REFORM Tracking ACO Growth Nationally OCTOBER 2012 The enclosed slides are intended to provide you with a snapshot of how private sector accountable care organizations (ACOs) have formed since
Outcomes-based payment for population health management
Outcomes-based payment for population health management February 10, 2016 Introduction PURPOSE OF THIS PAPER Since July 2014, the Delaware Center for Health Innovation (DCHI) has been convening stakeholders
E. Benjamin Money, MPH President/CEO NC Community Heath Center Association. NC Center for Nonprofits Public Policy Forum March 9, 2015
Basic Overview of NC Medicaid and Reform Proposals E. Benjamin Money, MPH President/CEO NC Community Heath Center Association NC Center for Nonprofits Public Policy Forum March 9, 2015 References: MEDICAID
New Practice Models in Pediatrics
New Practice Models in Pediatrics Susanne Madden & Chip Hart PCC User s Conference July 22, 2014 Agenda The Market Options Build Your Brand New Service Offerings Super Groups Urgent Care Direct Care Today
Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term
![Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term](/thumbs/30/14491472.jpg "Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term")
Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term services and supports (LTSS), including both home- and communitybased
Overview of Pending Payment Reform Legislation in Massachusetts
Overview of Pending Payment Reform Legislation in Massachusetts Presentation by Michael Bailit to: Minnesota Health Care Reform Task Force June 4, 2012 Context for Massachusetts Payment Reform 2006: Passage