The Direct Contracting Entity program is further proof of the federal government’s commitment to value-based care, but most DCE participants are missing a significant savings opportunity: post-acute care. Introduced in 2019 by the Center for Medicare and Medicaid Innovation (CMMI), the Direct Contracting Entity program (DCE) is building momentum in 2021. With 53 participants already […]
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CMS’s latest offering provides a significant opportunity for payers and providers, but those that can’t crack interoperability will struggle. On April 1, 2021, the first 53 organizations selected by CMS as Direct Contracting Entities (DCEs) kicked off their initial performance period. The second batch of DCEs will enter the model beginning their performance period in […]
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COVID-19 delivered a type of perfect storm filled with disrupted usage patterns and delayed elective surgeries with many opting for post-acute care at home due to fear of infection and facility lockdowns. Lower utilization rates meant that health plans found themselves falling below the medical loss ratio (MLR) limits—even as restrictions are gradually lifted, some […]
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Accountable care organizations (ACOs) that started in 2012 – the first year of the Medicare Shared Savings Program (MSSP) – decreased their post-acute care spending by a 9 percent differential reduction in two years without compromising care quality. In dollars, that 9 percent comes to $106 per beneficiary. That’s the finding of a recent JAMA Internal […]
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The shift away from fee-for-service toward value-based care is fully underway, and the reason for this move is clear. Healthcare costs are skyrocketing. Currently, healthcare represents almost 20 percent of the gross domestic product (GDP), and those costs are growing faster than the economy can keep up. The biggest steps toward curtailing healthcare expenses including […]
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Many healthcare professionals – especially those connected to skilled nursing facilities (SNF) – are extremely worried about the proposed tax plan coming out of the House of Representatives. The House recently passed a $4.1 trillion budget plan that promises deep cuts to social programs, including removing nearly $1 trillion from Medicaid’s budget over the next […]
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