Duo Health’s Post

In their new Forefront article, Katie Huber, Jonathan Gonzalez-Smith, Sherrie Wang, Mark Japinga, Frank McStay, Mark McClellan, and Robert Saunders from the Duke-Margolis Center for Health Policy discuss how specialist engagement in accountable care clarifies the key opportunities for better collaboration between primary and specialty providers and high-quality care across the care continuum, including the infrastructure that facilitates this collaboration, which supports the recommendations in CMS’s specialty care strategy and meeting CMS’s 2030 goal of accountable, longitudinal, coordinated care for all Medicare beneficiaries. "Improving meaningful specialist engagement in payment reforms is critical to achieving the Centers for Medicare and Medicaid Services’ (CMS’s) 2030 goal to have most Medicare and Medicaid beneficiaries in accountable care relationships, as affirmed by the CMS Innovation Center (Innovation Center) in its 2022 specialty strategy blog. Achieving this vision requires a range of strategies that consider the various ways specialists approach patient care and the practice contexts in which they operate. Specialty care providers interact with patients at different stages in the care continuum and practice in different clinical and organizational environments. The most common type of specialty payment model so far, bundled payments for episodic and acute medical events, reflects only one component of specialists’ impact on patient care. Specialists focusing more on longitudinal condition management—for common cardiovascular conditions, inflammatory bowel disease, or degenerative joint disease, for example—lack alternative payment models that reflect the type of care they provide." Read the full article here: https://bit.ly/3GQmcr7

Learn about how hospital consolidation impacts your costs and quality of care, the role of PBMs in managing patients’ weight-loss drug journey, the importance of Medicaid enrollment for maternal health outcomes, and more in this week's newsletter. https://lnkd.in/edsgAnaT

 🌟 Introducing the Making Care Primary (MCP) Model: A New Era in Primary Care On June 8, 2023, CMS announced the Making Care Primary (MCP) Model, set to launch on July 1, 2024. This innovative, voluntary model will be tested over 10.5 years in eight states, aiming to revolutionize primary care with enhanced care management, coordination, and community-based support. 🌐 Key Highlights: Enhanced Care Coordination: Seamless communication between primary care, specialists, and behavioral health providers. Chronic Disease Management: Targeted support for conditions like diabetes and hypertension. Behavioral Health Integration: Evidence-based screening and evaluation tools. Addressing Social Needs: Collaboration with community resources to meet housing, nutrition, and other social needs. Value-Based Care Support: Infrastructure, data analytics, and financial management tools to help practices succeed. At PharmD Live, we're excited to support the MCP Model through our comprehensive medication and disease management solutions. By investing in primary care and fostering better integration, we're committed to driving equitable access to care and improved patient wellness. 🚀 We look forward to the positive impact this model will have on both clinicians and patients. Together, we can make care primary! 🔗 Learn more about how PharmD Live can support this initiative and join the conversation on transforming primary care.https://https://lnkd.in/gfH3BgUj https://lnkd.in/e3mfxX_x #PrimaryCare #HealthcareInnovation #MCPModel #ChronicDiseaseManagement #BehavioralHealth #CommunityCare #ValueBasedCare #PharmDLive #HealthcareExcellence

Patient navigation services directly impact patients and promote better health outcomes, yet many provider organizations lack the funds to support them. Enter: ACO FLEX. The predictable revenue stream of this model can enable value-based care organizations to scale this service, among others, for their patients. Read two other examples of services enabled by ACO FLEX's prospective funds: https://lnkd.in/e34hGpk8 #acoflex #valuebasedcare #healthcareanalytics #VBC #patientnavigation

Healthcare is on the brink of some cool changes! We're seeing a big push towards value-based care, expanding to cover 90 million by 2027. This means better care through specialties like oncology and not just primary care. Also, with rising costs and staffing issues,AI is stepping in to streamline things. Think less admin hassle and more efficient care—exactly what we need right now. So, big moves are happening! It’s an exciting time as healthcare gets smarter and more focused on quality. #McKinseyInsights #HealthcareInnovation #DigitalHealth #ValueBasedCare

Wondering how #Chronic #Care #Management (CCM) can help your clinical practice in achieving patient care goals? Chronic Care Management (CCM) is a subset of virtual care management that focuses on providing coordinated care to patients with chronic diseases to improve their health outcomes, quality of life, and minimize healthcare expenditures. CCM is defined by the Centers for Medicare and Medicaid Services (CMS) as “care coordination services done outside of the regular office visit for patients with two or more chronic conditions expected to last at least 12 months or until the patient’s death, and the condition places the patient at the significant risk of death, acute exacerbation/decompensation, or functional decline.” Check out our latest blog to equip yourself with the basics of #CCM, its billing codes, eligibility criteria, program implementation, and more. Leave a #comment for any queries. #CCM #post #HealthArc #Chronic #Care #Management

CMS estimates that the new TEAM will save Medicare $481 million over 5 years! 💸 The TEAM model sets the stage for managing care episodes as a standard practice. Curious about the difference between TEAM and previous models like BPCI? We’ve got you covered in our latest blog. 💻 Read more about how this will impact hospitals starting in 2026. https://loom.ly/pEZ0AoQ #ValueBasedCare #HealthcareInnovation #CMSUpdates #HealthcareStrategy #HealthPolicy #RiskSharing #HospitalLeadership #AlternativePaymentModels

Elizabeth Fowler, Sarah Fogler, Claire Schreiber, Brian Waldersen, Genevieve Kehoe, Rachel Roiland, Sacha Wolf, Anna Goldman, and Purva Rawal from the Centers for Medicare & Medicaid Services discuss how the CMS Innovation Center has laid out a comprehensive specialty strategy to test models and innovations that support access to high-quality, integrated specialty care across the patient journey. "The first element of the Innovation Center’s specialty strategy aims to deliver enhanced specialty care data to clinicians, hospitals, and other health care entities across multiple models and programs. This requires a coordinated rollout of multiple data initiatives to support different kinds of providers and/or participants. The framework for data coordination and transparency is based on a survey of Accountable Care Organizations (ACOs) and advanced primary care model participants that asked what additional data would support specialty care engagement." Read the full article here: https://bit.ly/43LvZJN

Kaiser Permanente's acquisition of Geisinger Health this week has put value-based care back in the spotlight. However, for many providers and patients, the concept remains easier said than done as the fee-for-service model still dominates. If you're looking to get up to speed on value-based care, check out this brief primer on the subject. It covers the stakeholders involved and touches on why the model continues to lag behind the traditional fee-for-service model. It remains to be seen how this acquisition will impact the adoption of the value-based care model. If change is on the horizon, however, it will likely require additional investments and adjustments to existing performance measures. Check out the article below to learn more.

Our latest article discusses how #AccountableCareOrganizations (ACOs) can scale their services through #CareManagement strategies. Through effective care management delivery, ACOs can better address the unique needs of patients with #ChronicConditions to help ensure they receive the right care at the right time. https://lnkd.in/eWp-AxJw #HealthcareTechnology #ValueBasedCare #PatientCare