The pursuit of health equity in the United States has become more critical as healthcare disparities continue to affect millions of Americans. Socioeconomic status and access to healthcare services are pivotal in determining health outcomes, leaving underserved populations at a disadvantage. To address these issues, the Centers for Medicare and Medicaid Services (CMS) introduced changes in the Medicare Value-Based Purchasing (VBP) Program to incentivize quality care for all.  In this blog, we provide an update, discuss recent data and analyze the national impact. Read on for our interpretation of the CMS VBP Program and how it aims to advance health equity.   Understanding the Hospital VBP Program  The Hospital VBP Program aims to reward acute care hospitals with incentive payments based on their quality of care. This initiative ties a portion of Medicare payments to performance on quality measures, putting 2.0% of a hospital's base operating IPPS revenue at risk. CM...

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), has finalized a mandatory six-year model called the Increasing Organ Transplant Access (IOTA) Model .   This model,  finalized by the Biden-Harris administration,  is designed to address critical challenges in the nation’s kidney transplant system and significantly improve access to kidney transplants.  IOTA Model background  CMS has implemented various initiatives to improve care for patients living with kidney disease and address access to kidney transplantation. The IOTA Model builds on these efforts, enhancing organ availability and providing better education for patients, their families and caregivers.   The model aligns with previous CMS initiatives like the ESRD Treatment Choices (ETC) Model, launched in 2021, which emphasizes the use of home dialysis and increased access to kidney transplantation to improve the quality of...

As healthcare providers, understanding the specific health needs of the communities we serve has never been more important. A comprehensive Community Health Needs Assessment (CHNA) is an invaluable tool that enables healthcare organizations to evaluate the health priorities of a region, make data-driven decisions and ultimately offer more effective, equitable care.  What is a Community Health Needs Assessment?  A CHNA is a structured process in which healthcare organizations collect and analyze information about community health status, resources and needs. It’s an essential step for any healthcare provider committed to delivering patient-centered care that addresses acute and chronic health conditions and proactively supports community wellness. Learn how to get started with a CHNA , or check out our more recent  essential Community Health Needs Assessment (CHNA) guide.   The value of a comprehensive approach  Unlike basic health assessments, a comprehensi...

How does a CHA improve health equity in communities and beyond?   As county and municipal public health departments strive to understand and meet the unique needs of their populations, Community Health Assessments (CHAs) have become essential tools in guiding effective, data-driven healthcare. More than just a data collection effort, CHAs are pivotal in shaping public health priorities, addressing inequities and building lasting improvements in health outcomes across communities.   This blog explores what CHAs are, the frequently asked questions around them and the transformative impact they have on healthcare systems and the communities they serve.   What is a Community Health Assessment (CHA)?  Defining CHA   The Centers for Disease Control and Prevention (CDC) defines a Community Health Assessment (CHA) as a "state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensiv...

Coding outpatient visits might sound straightforward, but when it comes to Statewide Planning and Research Cooperative System (SPARCS) submissions, even minor errors can lead to major complications.   SPARCS plays a critical role in New York state’s healthcare system by collecting data that impact health policies, funding allocations and quality improvement initiatives across the state. However, with the constant evolution of guidelines and the high volume of outpatient encounters, healthcare providers face unique challenges to ensure compliance and data accuracy.  Keep reading to get a better sense of what’s needed to improve outpatient visit coding processes across your organization.  Main SPARCS challenges surrounding outpatient visits  1. Record nuances  For SPARCS data managers, one of the biggest challenges lies in translating the nuances of outpatient visits into compliant, accurate codes. Outpatient visits often include routine care, which doesn’t ...

On Nov. 25, the Centers for Medicare and Medicaid Services (CMS) released Performance Year (PY) 2022 evaluation findings for the Kidney Care Choices (KCC) voluntary model. The evaluation of the first performance year revealed mixed outcomes.  Kidney Care Choices model evaluation findings for PY 2022  Participation: 30% of Medicare fee-for-service beneficiaries with chronic kidney disease or end-stage renal disease eligible for the model are aligned with a KCC participating entity.    Encouraging trends: CMS reported , “The KCF model option increased the proportion of patients with ESRD dialyzing at home (20%). Home dialysis training increased in CKCC (32%). Both model options increased peritoneal dialysis, the primary modality for home dialysis (KCF: 26% and CKCC: 8%).”  Stable measures: Most quality measures showed no significant changes.  Financial outcomes: There was no measurable impact on overall Medicare costs, savings or losses.  The road a...

Third quarter 2024 Statewide Planning and Research Cooperative System (SPARCS) data submissions are due. In addition, the third final warning and Statement of Deficiency issue date for Q2 2024 is here. Keep reading for key dates that hospitals, ambulatory surgery centers and health systems need to know to remain SPARCS compliant.  [Download our quarterly calendar here]   Key compliance dates for SPARCS data: Q2 and Q3 2024  Q2 2024 SPARCS compliance deadlines  Dec. 15  Final third warning for Q2 2024 data   Hospitals that have not resolved their Q2 2024 data errors after receiving three warnings will be issued an SOD.   Jan. 15  SOD issued for Q2 2024 data   Hospitals will be issued an SOD.  Q3 2024 SPARCS compliance deadlines   Dec. 31  Submission deadline for Q3 2024 data   The deadline for submitting Q3 2024 SPARCS data falls on this date. Ensure your data are accurate and submitted on time to avoid penalties....