Podcasts about medicare shared savings program mssp

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Best podcasts about medicare shared savings program mssp

Latest podcast episodes about medicare shared savings program mssp

The ACO Show
189. Do ACOs Really Save Money? Dr. Amelia Bond and Dr. Dhruv Khullar Explain

The ACO Show

Play Episode Listen Later May 27, 2025 24:12


Dr. Amelia Bond and Dr. Dhruv Khullar join us to discuss the long-term savings of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP). Their recent study in JAMA found that ACOs generate increasing savings over time, with physician-led ACOs demonstrating more significant savings. Learn about their study's methodology, policy implications for The Centers of Medicare & Medicaid Services (CMS) and where Dr. Bond and Dr. Khullar will focus their research next. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Health Affairs This Week
Medicare Shared Savings Program Mints $2B Win for Value-Based Care w/ Frank McStay

Health Affairs This Week

Play Episode Listen Later Nov 22, 2024 16:48


Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers is joined by Frank McStay of Duke Margolis Institute for Health Policy to discuss the results of a recent CMS report that explores the impacts of the Medicare Shared Savings Program (MSSP) in 2023 and beyond. Health Affairs's Research and Justice For All podcast returns for its second season, focusing on drivers of health.Bookmark Health Affairs Forefront to keep an eye out for future articles from guest Frank McStay and colleagues. Related Articles:PRESS RELEASE: Medicare Shared Savings Program Continues to Deliver Meaningful Savings and High-Quality Health CareBuilding On CMS's Accountable Care Vision To Improve Care For Medicare Beneficiaries (Health Affairs Forefront)Do Teams Work Better Than Solo Providers? Spoiler Alert: Yes (A Health Podyssey) Subscribe to UnitedHealthcare's Community & State newsletter.

The ACO Show
149. Season 5 Premiere: Medicare's Value Based Care Results for 2022

The ACO Show

Play Episode Listen Later Sep 20, 2023 23:25


Season 5 of The ACO Show kicks off with Josh and Brian joined by Travis Broome, Aledade's Senior Vice President for Policy and Economics to discuss the 2022 Medicare Shared Savings Program (MSSP) results. As the largest and most successful value-based care program in American history, the results of this program tell us a lot about the progress of value-based care, and what that means for patients and primary care professionals around the country.

Sg2 Perspectives
MSSP: Bringing Accountable Care to All Medicare Beneficiaries

Sg2 Perspectives

Play Episode Listen Later Jan 11, 2023 13:29


The US's largest value-based payment model, the Medicare Shared Savings Program (MSSP), recently underwent changes designed to retain those organizations already involved and to encourage participation from new organizations. This week on Sg2 Perspectives, Sg2 Associate Principal Keely Macmillan joins us to talk about these changes (eg, a more gradual glide path to downside risk, the advancement of health equity) and how provider organizations—whether they are part of MSSP or not—should move forward. Learn more about MSSP and how Sg2 can help with your organization's value-based care strategy in Sg2's blog post and educational web series.   We are always excited to get ideas and feedback from our listeners. You can reach us at sg2perspectives@sg2.com, find us on Twitter as @Sg2HealthCare, or visit the Sg2 company page on LinkedIn.    

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BACON from the MaineHealth ACO
Provider Wellness & Great ACO Performance

BACON from the MaineHealth ACO

Play Episode Listen Later Nov 1, 2022 20:26


MaineHealth ACO President Jennifer Moore shares the latest quality and financial results from the ACO's participation in the Medicare Shared Savings Program (MSSP) and the Merit-based Incentive Payment System (MIPS). Plus, the MaineHealth Medical Group's new chief wellness officer, Christine Hein, MD, on current and future efforts to address provider wellness and burnout.

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Relentless Health Value
EP354: 7 Vital Success Factors to Stand Up a CIN (Clinically Integrated Network), With Shawn Rhodes

Relentless Health Value

Play Episode Listen Later Feb 10, 2022 32:44


In this healthcare podcast, we're gonna talk about the realities of setting up a clinically integrated network, otherwise known as a CIN. If only the whole process was unicorns and rainbows, but—as you likely suspected—it's not. Setting up a clinically integrated network is hard work, but the payoff for patients and clinicians alike can be worth fighting for. First of all, what is a clinically integrated network? It is a kind of ACO (accountable care organization). It is a legal entity that is a form of an ACO. So, every CIN is an ACO. But not all—in fact, most—ACOs are not CINs.  CINs enable coordinated care. Everybody in the network gets together to figure out how to enable clinicians to (for reals) follow their patients through multiple care settings and plan for an entire care journey. It can really help the patients navigate our crazy healthcare industry by giving them a trusted team that plots out a proactive path toward better healthcare outcomes and then make sure the patient stays on that path. It can be a really beautiful thing. Listen to EP349 with Lisa Trumble for real-world examples of the patient outcomes and experience a CIN can generate. All this for the patient while, at the same time, the total cost of care for Medicare patients goes down, I've heard, about 10% on average; but it can be more, as Lisa Trumble also talks about in episode 349 as aforementioned.  Alright … as we all know in healthcare, what's best for the patient doesn't, in so many cases, mean higher reimbursements. Sadly. So, what financial advantages does going through the time and trouble to create a CIN bring? There are basically four financial opportunities that can be realized with a CIN. I learned some of this from my guest today, Shawn Rhodes, who called strategically managing these four possible financial incentives “a delicate balance”; and as I get into some of them, you will see why. CIN Financial Opportunity #1: Similar to an ACO, if you're a CIN (because you are an ACO), you can participate in the Medicare Shared Savings Program, otherwise known as MSSP. The Medicare Shared Savings Program (MSSP) is the way that ACOs get paid a little something extra if they achieve savings goals for Medicare. The provider shares in the savings. Get it? And CINs are generally well equipped to realize these shared savings goals because to obtain the quality that you have to to pull off the shared savings, being clinically integrated really helps. CIN Financial Opportunity #2: Getting a gang of providers (doctors) together, you can do collective bargaining. So, back to basics with this one. You get a bunch of docs together in a region, then you all go to the big BUCAH plan—meaning the Blue Cross, the Cigna, the Aetna, Anthem, Humana—you go to them together and make your contracting demands, as opposed to each little doc practice going in all by yourself and trying to negotiate David and Goliath style. Now, what the payer might want from your collective crew there, the payer might insist on some kind of value-based agreement. Even if it's an FFS (fee-for-service) contract chassis, they'll attach some kind of quality or outcome component. So again, being organized in a CIN is a bonus either way. CIN Financial Opportunity #3: Your CIN can try to do direct contracting with local employers. Check out EP350 with Katy Talento for more on direct contracting. Actually, Lisa Trumble also mentions this in EP349.   CIN Financial Opportunity #4: Lastly, you can work with local hospitals' quality and efficiency programs. From a hospital financial perspective, they might be interested in the care that happens after an inpatient stay. If the outpatient care at an integrated skilled nursing facility, for example, is good, then the hospital could, for example, reduce readmissions. Now, caveat: I asked (maybe grilled is a better word) our guest in this episode, Shawn Rhodes, about this whole “prevent a readmission” business. Because on one hand, oh wow, you get a couple points back from having lower readmissions—which you can game all day long, by the way. Listen to the show with Dr. Rishi Wadhera (EP326) for more on how to not get dinged for readmissions even if you effectively have readmissions.   So, said another way, the crafty, albeit dubious, power move here if you're a hospital to maximize revenue is to let patients come back to the hospital after discharge but just don't call it a readmission. Call it, I don't know, observational. Then bill fee for service for the whole thing and get the reducing readmission financial incentives. At this point in the time-space continuum, everybody knows this stuff. This is not some kind of secret that I'm spilling here. Anyway, I bring this up because don't forget what I just said: The #4 CIN financial opportunity that Shawn Rhodes had mentioned is hooking up with a local hospital as part of their quality and efficiency program and the hospital looking to the CIN to reduce readmissions. Given the open secret on hospitals and readmissions, my Spidey sense just got really curious. So, when I pressed on this point, Shawn didn't talk about the CIN sharing any financial gains from the reducing readmission incentive program like I might have expected. Instead, he mentioned that having lower readmissions is a way for hospitals to get some negotiating leverage with payers. The next time your hospital's payer contract comes up, you can point to lower readmissions and then demand higher FFS fees. You also might be able to improve throughput of profitable service lines by reducing the number of patients who turn back up after their earlier procedure—which is another way, again, to increase FFS revenues, since the more patients you put through, the more revenue. This is why I like talking to people with a touchstone to the real world. You find out what the actual deal is. Now, I say all this to say that if patients get better care and their care journey is non-fragmented, it's a win-win. And CINs, like most ACOs, have been shown to trim the cost of care with great patient feedback. That's amazing. Just a quick spoiler here, but the seven parameters that Shawn Rhodes and I discuss in this episode which are essential for anyone who is looking to stand up a CIN or basically achieve success—and, I would guess, almost any value-based model—you gotta have an infrastructure that takes into account the following seven things: Patient-first and agile culture Interoperability Patient-centered processes Actionable information (not just data) Clinical integration Strategic planning and alignment of all stakeholders in the CIN Strong leadership My guest in this episode, Shawn Rhodes, has worked in performance and quality improvement for many years. He has worked at a CIN in Bowling Green, Kentucky; and he has overseen multiple value-based programs. Shawn currently serves as regional VP at Caravan Health. You can learn more at caravanhealth.com or connect with Shawn on LinkedIn.   Shawn Rhodes serves as regional vice president at Caravan Health, a services and technology company that helps hospitals and physicians who care for underserved population succeed in value-based care. Shawn collaborates with clients to develop tailored population health strategies and support their efforts to deliver the highest-quality, patient-focused care at the lowest cost. Prior to Caravan Health, Shawn served as the director of clinical integration for a clinically integrated network, Med Center Health Partners, where he oversaw value-based agreements (commercial, Medicare Advantage, Medicaid, BPCI, and employer health plans) with various payers along with ACO activities and quality improvement initiatives within the network. Before his work in value-based care, Shawn served as director of education and organizational development at Baptist Health Hardin, focusing on leadership development and cultural change through Studer Group initiatives. The early part of Shawn's career was spent in industrial equipment design and progressed into the automotive manufacturing industry working with Toyota and Honda on quality and process improvement. He then transitioned to the healthcare industry where he worked for eight years as a consultant specializing in coaching and mentoring hospitals to achieve improved quality, efficiency, and financial performance through process improvement, LEAN techniques, and reengineering. Shawn has a bachelor's degree in mechanical engineering and a master's degree in business administration from Western Kentucky University. He resides in Bowling Green, Kentucky. 08:08 What are the seven parameters to consider when standing up a CIN? 08:25 “Culture trumps strategy.” 09:10 “Communication and education are key components to starting that … process.” 09:26 “How do you get the information to the right person at the right time and the right place?” 09:36 What does interoperability need to look like in a CIN? 10:29 How do organizations communicate with the patient in a CIN? 11:07 Can a clinically integrated network work if it's not patient-centric? 11:37 EP332 with Tony DiGioia, MD.11:49 What's a must-have for a clinically integrated network to be successful? 13:41 “What does that data mean?” 15:34 EP315 with Bob Matthews.15:52 “You really need a go-to person.” 18:57 “The thing with team-based care is, you also have to have team-based accountability.” 20:54 “You've got to build some infrastructure around what you want to do.” 24:37 “Alignment is not an easy task by any means.” 25:15 “There has to be a group decision-making process.” 25:34 EP343 with David Carmouche, MD.25:41 EP341 with Gary Campbell.26:18 How do you define leadership? 27:49 “Start small, get some successes, and it will build as you go.” You can learn more at caravanhealth.com or connect with Shawn on LinkedIn.   Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork What are the seven parameters to consider when standing up a CIN? Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “Culture trumps strategy.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “Communication and education are key components to starting that … process.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “How do you get the information to the right person at the right time and the right place?” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork What does interoperability need to look like in a CIN? Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork How do organizations communicate with the patient in a CIN? Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork Can a clinically integrated network work if it's not patient-centric? Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork What's a must-have for a clinically integrated network to be successful? Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “What does that data mean?” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “You really need a go-to person.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “The thing with team-based care is, you also have to have team-based accountability.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “You've got to build some infrastructure around what you want to do.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “Alignment is not an easy task by any means.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “There has to be a group decision-making process.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork How do you define leadership? Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork “Start small, get some successes, and it will build as you go.” Shawn Rhodes, regional VP at @CaravanHealth, discusses #CINs on our #healthcarepodcast. #healthcare #podcast #clinicallyintegratednetwork   Recent past interviews: Click a guest's name for their latest RHV episode! Pramod John (EP353), Pramod John (EP352), Dr Eric Bricker, Katy Talento, Stacey Richter (INBW33), Stacey Richter (INBW32), Dr Steve Schutzer (Encore! EP294), Lisa Trumble, Jeb Dunkelberger, Dr Ian Tong, Mike Schneider, Peter Hayes, Paul Simms, Dr Steven Quimby, Dr David Carmouche (EP343), Christin Deacon, Gary Campbell, Kristin Begley, David Contorno (AEE17), David Contorno (EP339), Nikki King, Olivia Webb, Brandon Weber, Stacey Richter (INBW30), Brian Klepper (AEE16), Brian Klepper (EP335), Sunita Desai, Care Plans vs Real World (EP333)

A Second Opinion with Senator Bill Frist, M.D.
159 - Shawn Morris, CEO of Privia Health, Shares Their Exciting, National Physician Enablement Model Focused on Quality Care & Physician Well-Being

A Second Opinion with Senator Bill Frist, M.D.

Play Episode Listen Later Dec 27, 2021 63:38


This episode is brought to you by MEDHOST, a Trusted EHR for Healthcare Facilities. To learn more, go to Medhost.com. Shawn Morris is CEO of Privia Health, an exciting, national physician enablement company that's shaking up primary care and other specialty areas. Shawn has led Privia since 2018, expanding into new provider areas including California and West Texas, and successfully taking it public this year.  Privia was recently recognized among Inc. Magazine's Best-Led Companies for 2021. Shawn previously served as the President and COO of Cigna-Healthspring, overseeing Cigna's multi-billion dollar Medicare Advantage business. In today's discussion, he brings his extensive knowledge of the insurance market, and how to equip physicians with the tools they need to deliver the high-value care they want to provide – and consumers want to receive. For more on Privia Health: Privia Health's Chief Clinical Officer, Keith Fernandez, MD, and Chief Medical Officer of Privia Medical Group — Mid-Atlantic, Fred Taweel, MD, were recently featured by the American Medical Association regarding Privia's ACO success within the Medicare Shared Savings Program (MSSP) for the 2020 performance year. Read it here: https://www.ama-assn.org/practice-management/payment-delivery-models/physician-leaders-patient-access-drive-privia-health-s

K&L Gates Health Care Triage
COVID-19: K&L Gates Triage: Value-Based Payment Arrangements

K&L Gates Health Care Triage

Play Episode Listen Later May 7, 2020 18:31


In this week’s episode, Limo Cherian, Carla Dewberry and Steven Pine discuss recent changes to value-based health care payment arrangements triggered by the current COVID-19 emergency. In particular, the presenters discuss changes implemented by CMS to the Quality Payment Program (QPP), the Merit-based Incentive Payment System (MIPS), and the Medicare Shared Savings Program (MSSP), as well as additional considerations for commercial value-based arrangements.

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Relentless Health Value
EP220: Episodes of Care Payments: A Lower-Risk Way to Take On Risk, With François de Brantes of Remedy Partners

Relentless Health Value

Play Episode Listen Later Mar 21, 2019 28:17


Today we’re talking episodes of care payment models, otherwise known as bundled payments. Just to catch you up if you’re unfamiliar, this type of payment model means that a health care provider packaging together all the services needed during an episode and charges a guaranteed price for guaranteed quality of care. If we’re talking about government payments, about 50% of, for example, knee surgeries are paid for right now in an episode of care fashion. In the private pay landscape, that number is lower but growing. Bundles have advantages to purchasers (ie, employers or taxpayers who are the ultimate payers) because it’s possible to predict and compare the target price they’ll pay. But it’s also important for consumers who are partial payers in most cases. Bundles make health care prices transparent in a way that fee for service (FFS) can never manage. Today I speak with François de Brantes, senior vice president at Remedy Partners and a noted expert in episodes of care and bundled payment initiatives. François also actively supported the launch of the Leapfrog Group, created Bridges to Excellence, and led the development and implementation of PROMETHEUS Payment. You can learn more at remedypartners.com. François de Brantes is senior vice president of commercial business development at Remedy Partners. He has spent nearly 20 years advocating for, and working to transform, the US health care system by improving incentives for providers and consumers to encourage value-based decisions. Prior to joining Remedy Partners, he was executive director of the Health Care Incentives Improvement Institute (HCI3), a not-for-profit company that designed programs to motivate physicians and hospitals to improve the quality and affordability of health care delivery. Early in his career at General Electric, he was involved in many strategic programs that rewarded providers for better performance. He has written extensively about the topic, including his 2013 book, The Incentive Cure: The Real Relief for Health Care. 02:04 The new Medicare Shared Savings Program (MSSP) and how it intersects in this conversation. 03:02 Why physicians need an advanced alternative payment model. 04:01 Why episode of care makes sense. 04:40 Why upside-only deals are not financially sustainable. 06:16 A manageable financial risk. 07:34 Taking on total cost of care and the small percentage of significant potential variability. 08:37 “The only way to avoid the almost-certain variability that is going to accrue on that half of 1% is if you have a lot of patients.” 09:12 The “danger zone” of Medicare beneficiaries. 11:55 “Either you’re in total cost of care, or it’s episodes.” 13:59 Quality of care vs bundled payments. 18:20 “Let’s not forget … that the reason why we’re doing … this … is because consumers, directly and indirectly, are paying the price.” 19:00 Dave Chase’s books and health care in the middle class. 19:42 The wealth of savings in post-acute care. 21:19 How to demonstrate the value you’re bringing to that episode of care. 21:47 Broad strokes of integrated delivery systems that provide value. 22:08 The next logical solution in integrated delivery systems and episode of care payment programs. 22:28 “They’re going to take on much more of the role of the care coordinator.” 23:43 “It’s not just the integrated systems; it’s really the physicians who … are taking responsibility for what happens.” 24:00 Michael Hunt and formalized, evidenced-based ways to evaluate post-acute facilities. 24:22 Remedy Partners and François’s role in episodes of care. You can learn more at remedypartners.com.

HIT Breakdown
HIT Breakdown 35 - Preparing for changes to value-based care reimbursement in 2019

HIT Breakdown

Play Episode Listen Later Dec 19, 2018 24:03


In August 2018, CMS unveiled its proposed “Pathways to Success” program – an overhaul of the existing Medicare Shared Savings Program (MSSP), which would redesign participation options for Accountable Care Organizations (ACOs). It’s anticipated that the proposed program will pass in 2019. That means ACOs will need to prepare to transition from a multi-track reimbursement model to a two-track model, among other changes. Jake Aleckson, director of Optimization Solutions, and Steve Bloom, project director of Strategic Services, have been closely monitoring these proposed changes and how they will impact ACOs. Jake and Steve discuss the changes ACOs can anticipate from the new MSSP in 2019, providing a breakdown of the consolidated tracks, reimbursement rates, and ways organizations can demonstrate value-based care. If you’d like to learn more or need help optimizing your value-based reimbursement program, please reach out.

HIT Breakdown
HIT Breakdown 34 - Expert advice on preparing your MSSP submission

HIT Breakdown

Play Episode Listen Later Nov 14, 2018 34:06


  The end of the year is quickly approaching, and if you’re an Accountable Care Organization (ACO) you’ve likely already started planning for your Medicare Shared Savings Program (MSSP) submission. This process is critical to helping your organization demonstrate you’ve met the necessary quality measures to receive reimbursement from CMS at year-end. MSSP submission, while necessary, can be somewhat complicated. To help your organization successfully navigate this complex process, Jake Aleckson, director of Optimization Solutions, and Kyle McAllister, a senior consultant on the optimization team, break down the key areas of focus for your population health and quality management teams. They offer tips and advice around the tools, timelines, and data extraction options your team should consider when putting together your submission for CMS. If you’re interested in learning more about the MSSP submission process, or need our assistance with your submission, please contact us.  

The Healthcare Policy Podcast ®  Produced by David Introcaso
150th Interview: Tim Gronniger Discusses the Current Proposed Medicare Accountable Care Organization (ACO) Rule (October 3rd)

The Healthcare Policy Podcast ® Produced by David Introcaso

Play Episode Listen Later Oct 4, 2018 31:21


Listen NowCurrently, CMS is accepting public comment on a proposed Medicare Shared Savings Program (MSSP), known more commonly as the Accountable Care Organization (ACO) program, rule.  The MSSP, created under the 2010 Affordable Care Act, is Medicare's flagship pay or performance program currently providing care to over 10 million Medicare beneficiaries.  MSSP or ACO performance, or to the extent the program has reduced Medicare spending growth, has been widely debated largely because CMS has failed to evaluate the program  Under this administration the program has come under substantial criticism.  The proposed rule, published this past August 17 in the Federal Register, is this administration's effort to improve the program's performance moreover by reducing the number of years an provider can participate in the program, from six years to two, without taking financial risk or participate in what are termed upside only contracts.  The administration argues absent financial risk providers do not fully engage in practice reforms to reduce spending.  This assumption is also widely debated.  Absent other substantial payment innovations, the success of the MSSP or ACO program is vital to the Medicare program, now forcasted to go bankrupt in 2026. During this 30 minute conversation Mr. Gronniger begins with a a brief overview of Caravan's work, he discusses or explains what success the ACO program has achieved to date and the program's background.  He moves onto discussing numerous elements of the proposed rule including earned shared savings percents, risk adjustment, aspects of financial benchmarking, low and high revenue ACOs, and beneficiary engagement and incentives, among others.     Mr. Tim Gronniger is currently the Senior Vice President of Development and Strategy at Caravan Health.  Previously, he served as Chief of Staff and Director of Delivery System Reform at CMS.  Previous to that, Mr. Gronniger  was Senior Adviser for Health Care Policy for the White House Domestic Policy Council.  Before that he served as senior professional staff to the Ranking Member of the House Committee on Energy and Commerce, Rep. Henry Waxman (D-CA, now retired).  Mr. Gronniger began his career in Washington, D.C. at the Congressional Budget Office where he studied or scored Medicare and Medicaid legislation.  Mr. Gronniger holds a Masters in Public Policy and Health Services Administration from the University of Michigan and a BA in Biochemical Sciences from Harvard. The proposed ACO rule is at: https://www.federalregister.gov/documents/2018/08/17/2018-17101/medicare-program-medicare-shared-savings-program-accountable-care-organizations-pathways-to-successFor information concerning Caravan Health go to: https://caravanhealth.com/ This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

K&L Gates Health Care Triage
K&L Gates Triage: A New Proposed Pathway for the Medicare Shared Savings Program Part 2, in a 2-Part Series

K&L Gates Health Care Triage

Play Episode Listen Later Aug 31, 2018 11:18


The Centers for Medicare & Medicaid Services (“CMS”) recently proposed a major redesign of its Medicare Shared Savings Program (“MSSP”) under a new plan it calls “Pathways to Success.” In this Part II of the two-part series on the proposed MSSP changes, Steve Pine discusses changes to ACO benchmarking, beneficiary notifications, and EHR certifications. He also summarizes CMS’ request for information on methods to facilitate care coordination and modify Medicare fraud and abuse waivers. Presenters: Steven G. Pine Download Presentation Materials    

K&L Gates Health Care Triage
K&L Gates Triage: A New Proposed Pathway for the Medicare Shared Savings Program Part 1, in a 2-Part Series

K&L Gates Health Care Triage

Play Episode Listen Later Aug 16, 2018 6:19


The Centers for Medicare & Medicaid Services (“CMS”) recently proposed a major redesign of its Medicare Shared Savings Program (“MSSP”) under a new plan it calls “Pathways to Success.” In this Part I of a two-part series on the proposed MSSP changes, Limo Cherian discusses the structural changes included in the proposal and how these changes would affect current risk-sharing models. Presenters: Limo T. Cherian Download Presentation Materials

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K&L Gates Health Care Triage
K&L Gates Triage: ACO Improvements in the Bipartisan Budget Act of 2018 (Part 2)

K&L Gates Health Care Triage

Play Episode Listen Later May 10, 2018 6:40


In the second segment of this two-part series discussing recent program changes introduced by the Bipartisan Budget Act of 2018 for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP), Kathy Barger discusses new improvements in telehealth coverage for certain ACOs and new beneficiary incentive opportunities for qualifying primary care services. Presenter: Kathy G. Barger Download Presentation Materials

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K&L Gates Health Care Triage
K&L Gates Triage: ACO Improvements in the Bipartisan Budget Act of 2018 Part 1

K&L Gates Health Care Triage

Play Episode Listen Later May 3, 2018 7:16


The Bipartisan Budget Act of 2018 recently introduced three noteworthy program improvements for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) aimed at increasing program flexibility. In the first segment of this two-part series discussing these changes to the MSSP, Steve Pine discusses modifications to beneficiary assignment and how ACOs may benefit from the new rules. Presenter: Steven G. Pine Download Presentation Materials

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This Week in Health Innovation
@FLAACOs CEO @NicoleBradberry weighs in on ACO results and 3rd Annual Conference

This Week in Health Innovation

Play Episode Listen Later Sep 19, 2016 32:00


On the Friday, September 16th, 2016 broadcast of PopHealth Week our special guest was the CEO of a pioneering state organzation enabling the success and support of Accountable Care Organizations in the the state of Florida, Nicole Bradberry. During the broadcast we'll get this industry veteran and innovator to weigh in on the significance of the recent CMS results reporting of ACOs participating in the Medicare Shared Savings Program (MSSP). and a preview of the upcoming 3rd Annual FLAACO gathering in Orlando, Florida.  For more information click here, and for a summary take on CMS's results reporting click here.  And for our prior chat's with Nicole, click here, and here.

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PopHealth Week
Meet Nicole Bradberry, CEO FLAACOs

PopHealth Week

Play Episode Listen Later Sep 16, 2016 31:00


On Friday, September 16th, 2016 our special guest is the CEO of a pioneering state organzation enabling the success and support of Accountable Care Organizations in the the state of Florida, Nicole Bradberry. During the broadcast we'll get this industry veteran and innovator to weigh in on the significance of the recent CMS results reporting of ACOs participating in the Medicare Shared Savings Program (MSSP). and a preview of the upcoming 3rd Annual FLAACO gathering in Orlando, Florida.  For more information click here, and for a summary take on CMS's results reporting click here.  And for our prior chat's with Nicole, click here, and here.  

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HealthSounds
For Success in Accountable Care Models, Educate Providers on the Ground

HealthSounds

Play Episode Listen Later Apr 14, 2016 3:26


Whether an ACO is assessing readiness for CMS’s Next Generation ACO model or is already a Medicare Shared Savings Program (MSSP) participant, face-to-face education of non-executive providers living the day-to-day ACO reality is critical to that accountable care organization’s viability, advises Travis Ansel, senior manager of strategic services for Healthcare Strategy Group. Even within experienced MSSP ACOs, providers often don’t understand MSSP quality goals, the relationship of their actions to cost management or MSSP data requirements, noted Ansel. In this broadcast, Ansel describes the two biggest barriers to success across all ACO models, and offers two tips to organizations wishing to prosper in the value-based care reimbursement world.