Many CMS value-based care models seek to improve care coordination and reduce Medicare fee-for-service spending through episode-based payment and practice transformation. The agency’s new Enhancing Oncology Model applies these objectives to cancer care. There are many good reasons for any oncology practice to join EOM and improve the delivery of cancer care to its patients. But value-based care also raises the stakes. Participation alone doesn't guarantee success. Using analytics helps providers “trust but verify” ─ to not simply believe they are improving care quality and reducing costs, but know where they stand through tangible metrics. This blog post explores three best practices that help ingrain analytics in EOM practice, redesign and performance. How to anchor analytics for EOM performance 1. Estimate episode target prices for financial analyses Financial realities dictate whether practices join EOM, under what risk arrangement and if it's for the long term. Participati...

On June 8, CMS announced the new Making Care Primary Model that will run for 10.5 years, from July 1, 2024, to Dec. 31, 2034. To ensure you’re ready for the application process, this blog will explain what you need to know about MCP. What is Making Care Primary? The MCP model aims to make advanced primary care more available and sustainable. This model builds upon previous innovative primary care models over the past 10 years, including the Comprehensive Primary Care Initiative, Comprehensive Primary Care Initiative Plus and Primary Care First. State participation in MCP CMS announced that the MCP multi-state initiative will be tested under the Center for Medicare and Medicaid Innovation in eight states: New York, Massachusetts, New Jersey, North Carolina, Minnesota, Colorado, New Mexico and Washington. Based on what we know so far, let’s dive into the top five things you’ll need to know about this program. 1. MCP lasts 10.5 years The model duration (10.5 years) for the CMS MCP model...

  The Agency for Healthcare Research and Quality’s Surveys on Patient Safety Culture™ polls staff for their opinions every two years. That is an eternity inside facilities where big changes can happen fast: from patient referral trends to quality improvement focus to workforce turnover. With all these demands, it’s easy for safety and culture to become just words and the importance of the SOPS® to lapse over time — among those who administer it and those who complete it (or don’t). With creative ideas and proven response rate tactics , hospitals can use the SOPS® survey to reinforce positive awareness and participation, support more patient safety activities and promote efforts that celebrate wins and build on successes.  1. Raise patient safety and survey awareness among staff Relevant, fresh communications are important, so frame each survey as a new opportunity to elevate patient safety. Awareness campaigns can promote time blocks to complete the survey and quick survey wi...

CMS’ new Enhancing Oncology Model seeks to improve cancer care coordination, drive practice transformation and reduce Medicare fee-for-service spending through episode-based payment. Launched July 1, EOM replaces the Oncology Care Model as CMS seeks to build on lessons learned and challenges of cancer care cost management. In this blog, we explore five best practices your oncology practice can use to kick-start EOM. How to operationalize your Enhancing Oncology Model 1. Lay the foundation with core value-based care principles While CMS models change, many value-based care elements are evergreen and can benefit from practices that: identify physician champions; inform and align practice leadership; define success markers to track progress; identify core team member roles and goals; and establish quality measure reporting. The latter may require EOM practices to add metrics to their electronic health records, such as depression screening and pain management. While this example is model-...

First off, congratulations to you and your practice for achieving National Committee for Quality Assurance Patient-Centered Medical Home recognition! Gaining NCQA PCMH status is a big accomplishment for which you should be very proud. Now that you’ve completed the necessary steps to implement changes and earn recognition, you may be wondering what’s next. In this guide, we’ll navigate what to do next, PCMH standards and guidelines to follow and 2024 annual reporting requirements to focus on. Let’s get into it! What to do after earning NCQA PCMH recognition Before you’re ready to start earning the great benefits of PCMH recognition , you need to plan what actions you’ll take to maintain your status. Remember, PCMH is not a project, but a continual progression of the way care is delivered to patients, meeting them where they are. So, if you’re a practice that wishes to keep its PCMH, you’ll need to be accountable for each criterion you achieved when initially receiving PCMH recognition. ...

  Authorized by the Affordable Care Act and established in 2012, the Medicare Shared Savings Program is one of CMS’ first accountable care organization models. For the first time in MSSP’s history, the agency will offer payments upfront to encourage more providers to participate. The new Advance Investment Payments option for MSSP participants will begin with performance year 2024. Who is eligible for Advance Investment Payments and what do they receive? Per the CMS AIP guidance , Advance Investment Payments delivers a one-time $250,000 payment upfront to eligible providers who might not otherwise participate in value-based care. These models require substantial infrastructure investments (e.g., technology, staffing, data and analytics partners). CMS will also offer additional quarterly payments per beneficiary per quarter for the first two performance years if the ACO has met MSSP eligibility and compliance requirements. AIP is only available for ACOs who: have never participated ...

What are the hallmarks of an effective public health department?  Public health accreditation may not be the first answer that comes to mind. But the  Public Health Accreditation Board  created a framework that can help health departments transform their quality, accountability and performance. The  Community Health Assessment  anchors the PHAB framework, which includes 10 Essential Public Health Services aligned to 10 domains and eight key public health capabilities. To improve your application process, it’s essential to see how your CHA affects your public health accreditation. These are the five things you need to know now.  1.  Accreditation is prevalent but takes time Per the CDC, 80% of state public health departments are PHAB accredited, as are hundreds of  local and tribal agencies . These achievements didn’t happen overnight. Public health departments may lack the time, staff, data and partnerships to refine their CHAs, much less lev...