ICYMI: Notes from the field for August 2020

DATE: August 31, 2020

With each month, we learn more about how COVID-19 is transmitted and the effects of this pernicious disease on those who contract it — as well as the effects of the pandemic on the U.S. economy and the healthcare industry. Taking the pandemic into consideration, CMS continues to adjust its models to support hospitals and providers and encourage adoption of value-based care. Here are recent topics and perspectives of interest.

COVID-19 pandemic

Since the rise of COVID-19, canceled procedures, personal protective equipment costs and other expenses have cost hospitals $50.7 billion per month. Hospitals nationwide are expected to lose $120+ billion more before year end. In this RevCycle Intelligence article, healthcare leaders consider the long-term effects of the pandemic on care delivery and payment. Among their conclusions: payment reform will be essential for financial resiliency.

The COVID-19 pandemic has accelerated the trend of providers willing to adopt financial risk and sheds light on the value of predictable revenues like capitation. The article offers three steps accountable care organizations can take, with the help of their physicians, to control costs.

In another perspective, this HealthAffairs blog asks: will the pandemic delay the transition to value-based care? The blog suggests steps CMS should take to protect existing ACOs and encourage non-participating primary care providers and hospitals to make the transition to VBC.

Value-based care

This HealthLeaders article about the goals of CMS and the benefits of value-based models cites our recent survey of provider organizations.

CMS introduced a new model that aims to support rural providers in transforming care delivery. If your organization fits this description, how would the new Community Health Access and Rural Transformation (CHART) Model participation tracks affect you? Learn more.

The Medicare Shared Savings Program and bonus adjustments are part of The Value in Health Care Act, proposed by Congress, which would help family physicians participate in VBP models and ACOs. The Value Act is supported by many of the country’s largest medical organizations. Learn how it could affect your practice.

Value-based care can save primary care practices. In this Medical Economics interview, Farzad Mostashari, MD, shares his vision of the future of primary care, saying physicians should embrace risk.

Healthcare C-suite titles are constantly expanding, and chief of government programs is among the latest. “When I see C-suite invest in a new C role around something like value-based care, it’s saying, ‘This is important to us.’” Read more in Managed Healthcare Executive.

How has Community Care Cooperative, a federally qualified health center, saved Massachusetts $12.2 million by creating an ACO? Here’s how provider organizations can embrace value-based care while supporting the bottom line.

Other news

CMS has proposed making the use of telehealth by Medicare providers for home visits permanent. Read more about the proposed changes in this Modern Healthcare article. Stakeholders are invited to suggest additional telehealth services that should be extended after the public health emergency subsides.

A team of researchers have identified a method to reduce bundled payment costs for total joint arthroplasty patients by discharging them to skilled nursing facilities after the procedure. Could CMS use this strategy in other models?