GAO calls data used to determine physician pay potentially flawed
Federal investigators say the current process to review and recommend how Medicare pays doctors leaves it susceptible to inaccurate reporting and conflicts of interests.
A report released Thursday by the Government Accountability Office found “weaknesses” in the survey data used by the American Medical Association/Specialty Society Relative Value Scale Update Committee, also known as RUC.
Investigators said the committee's recommendation process “relies on the input of physicians who may have potential conflicts of interest with respect to the outcomes of CMS's process.”
New Affordable Care Act payment model seeks to reduce cardiovascular disease
Speaking today at the White House Conference on Aging regional forum in Boston, Health and Human Services Secretary Sylvia M. Burwell announced a unique opportunity for health care providers to decrease cardiovascular disease risk for tens of thousands of Medicare beneficiaries by assessing an individual patient’s risks for heart attack or stroke and working with them to reduce those risks.
Top Medicare prescribers get top payments from drugmakers: Modern Healthcare
Pharma companies that make payments to doctors--and the doctors who receive those payments--have repeatedly insisted there's no link between those payments and prescriptions. But data on Medicare's top script writers may have them answering for it all over again.
Nearly one-fourth of Medicare's 400 most prolific prescribers in 2013--those who prescribe at least $1 million worth of meds in the Medicare Part D program--pocketed consulting fees or other financial perks from the makers of those very drugs, according to a
analysis of Part D data and the Open Payments database.
Innovation Pulse: Meet the new CMS code worth $17 billion annually
Travis Bond spoke plainly but with a sparkle in his eye when he confessed: “We just got lucky.”
Bond, CEO of personal health record company CareSync, was referring to CPT code 99490 – something of a sleeping giant in the Centers for Medicare and Medicaid Services 2015 Physician Fee Schedule that has the potential to be rather lucrative for providers and the IT innovators who serve them.
The meaningful use program incentivized hospitals to adopt electronic health records and the $30 billion CMS has thus far disbursed, in turn, has lured a rush of vendors to innovate with electronic health records software (albeit arguably within certain detrimental confines). And the new code carries a strikingly similar potential, as many health systems will have to invest in platforms that enable them to care for patients in accordance with 99490.
Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation
In January 2014, the Affordable Care Act (ACA) began making federal premium tax credits available to eligible individuals who purchased health coverage through exchanges, or Marketplaces. These subsidies are a centerpiece of the law and are designed to provide financial assistance to millions of Americans who could not otherwise afford health coverage.
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AAMC Collaborative Care Network, LLC
Accountable Care Alliance of Ventura, LLC
Accountable Care Clinical Services, PC
Accountable Care Coalition of Caldwell County, LLC
Accountable Care Coalition of Central Georgia, LLC.
Accountable Care Coalition of Coastal Georgia, LLC
Accountable Care Coalition of DeKalb, LLC.
Accountable Care Coalition of Eastern North Carolina, LLC
Accountable Care Coalition of Georgia, LLC.
Accountable Care Coalition of Greater Athens Georgia II, LLC.
Accountable Care Coalition of Greater Athens Georgia, LLC
Accountable Care Coalition of Greater Augusta & Statesboro, LLC.
Accountable Care Coalition of Greater Houston, LLC.
Accountable Care Coalition of Greater New York, LLC.
Accountable Care Coalition of Green Mountains, LLC
Accountable Care Coalition of Maryland Primary Care, LLC.
Accountable Care Coalition of Maryland, LLC.
Accountable Care Coalition of Mississippi, LLC.
Accountable Care Coalition of Mount Kisco, LLC
Accountable Care Coalition of North Central Florida, LLC.
Accountable Care Coalition of North Texas, LLC.
Accountable Care Coalition of Northwest Florida, LLC
Accountable Care Coalition of South Georgia, LLC.
Accountable Care Coalition of Southeast Wisconsin, LLC
Accountable Care Coalition of Syracuse, LLC
Accountable Care Coalition of Texas, Inc.
Accountable Care Coalition of The Tri-Counties, LLC
Accountable Care Coalition of Western Georgia, LLC
Accountable Care Options, LLC
Accountable Care Organization of New England, LLC
Accountable Care Organization of Puerto Rico, Inc.
Accountable Care Organization of the North Country, LLC
Accountable Care Partners, LLC
Accountable Healthcare Alliance, PC
Accountable Physicians of North Mississippi, Inc.
ACO Providers of Central Texas
Adena Healthcare Collaborative, LLC
Adirondacks ACO, LLC
Advanced Premier Physicians ACO
Advocare Well Network
Advocate Physician Partners Accountable Care, Inc.
Affiliated Physicians Medical Group ACO, Inc.
Akira Health of Fresno Inc.
Akira Health of Los Angeles Inc
Akira Health, Inc.
Aledade Delaware ACO LLC
Aledade Primary Care ACO LLC
Alegent Health Partners, LLC
Alexian Brothers Accountable Care Organization
Allcare Options, LLC
Allied Physicians ACO, LLC
Amarillo Legacy Medical ACO
American Health Alliance, LLC
American Health Network of Ohio PC
American Rural ACO
AnewCare Collaborative, LLC
Antelope Valley ACO
APCN-ACO, A Medical Professional Corporation
ApolloMed Accountable Care Organization Inc.
AppleCare Medical ACO, LLC
Arizona Care Network LLC
Arizona Connected Care, LLC
Arizona Priority Care Plus
Arkansas Accountable Care, LLC
Arkansas Health Network LLC
Arkansas High Performance Network ACO of CAH
Arkansas High Performance Network ACO of FQHC, LLC
Arkansas HIgh Performance Network ACO, LLC
Asian American Accountable Care Organization
AtlantiCare Health Solutions, Inc.
Augusta Care Partners, LLC
Aurora Accountable Care Organization LLC
Barnabas Health ACO-North, LLC
Baroma Health Partners (FL)
Baroma Health Partners (LA)
Bassett Accountable Care Partners, LLC
BayCare Physician Partners ACO, LLC
Baylor Scott & White Quality Alliance
Bayview Physicians Group
Beacon Health Partners, LLP
Beth Israel Deaconess Hospital-Plymouth
BHS Accountable Care LLC
BJC HealthCare ACO, LLC
Bluegrass Clinical Partners LLC
BMC Integrated Care Services, Inc.
Broward Guardian, LLC
Buena Vida y Salud LLC
Cadence Health ACO, LLC
Cambridge Health Alliance
Cape Cod Health Network ACO
Cape Fear Valley Accountable Care Organization, LLC
Capital Health Accountable Care Organization, LLC
Care Coordination Services, LLC
Caribbean Accountable Care, Inc.
Carolina Medical Home Network Accountable Care Organization LLC
Carolinas ACO, LLC
Carroll ACO, LLC
Catholic Medical Partners-Accountable Care IPA, Inc.
Cedars-Sinai Medical Care Foundation
Central Florida Physicians Trust
Central Jersey ACO LLC
Central Maine ACO
Central Missouri Medical Network
Central US ACO, LLC
Central Utah Clinic, P.C.
CHA ACO, LLC
Chautauqua Region Associated Medical Partners, LLC
CHI St. Luke's Health Network
Chicago Health System ACO, LLC
Christie Clinic Physician Services, LLC
Chrysalis Medical Services, LLC
Circle Health Alliance, LLC
Cleveland Clinic Medicare ACO, LLC
Cleveland Quality Healthnet
Clinical Partners of Colorado Springs, LLC
CMG ACO, LLC
Coastal Carolina Quality Care, Inc.
Coastal Medical, Inc.
Coastal Plains Network, LLC
Collaborative Care of Florida LLC
Collaborative Health ACO
Colorado Accountable Care, LLC
Commonwealth Primary Care ACO
Community Health Accountable Care, LLC
Community Health Network
Connected Care, LLC
Cornerstone Health Care, PA
Cornerstone Health Enablement Strategic Solutions, LLC
Cotton-O'Neil ACO llc
Covenant ACO, Inc.
Crystal Run Healthcare ACO, LLC
Cumberland Center for Healthcare Innovation, LLC
Deaconess Care Integration, LLC
Dean Clinic and St. Mary's Hospital ACO
Delaware Valley ACO
Delmarva Health Network
Diagnostic Clinic Walgreens Well Network
Doctors ACO, LLC
Duke Connected Care, LLC
Essential Care Partners II, LLC.
Essential Care Partners, LLC
FamilyHealth ACO, LLC
First Coast Health Alliance, LLC
Florida Medical Clinic ACO, LLC
Florida Physicians Trust, LLC
Foothill Accountable Care Medical Group, Inc.
Fort Smith Physicians Alliance ACO, LLC
FPG Healthcare, LLC
Franciscan AHN ACO, LLC
Franciscan Alliance ACO
Franciscan Northwest Physicians Health Network, LLC
Franciscan Riverview Health ACO
Franciscan Select Health Network ACO, LLC
Franciscan Union ACO
Frederick Integrated Healthcare Network LLC
Genesis Accountable Care Organization, LLC
Genesis Accountable Physician Network, LLC
Genesys PHO, L.L.C.
Georgia Physicians for Accountable Care, LLC
GGC ACO, LLC
Golden Life Accountable Care Organization (ACO)
Good Help ACO
Greater Baltimore Health Alliance
Gulf Coast Health Partners
Hackensack Alliance ACO
Harbor Medical Associates, PC
Hartford Healthcare Accountable Care Organization, Inc.
HCP ACO California, LLC
Health Alliance Integrated Care, LLC
Health Choice Care, LLC
Health Collaborative of Central Ohio LLC
Health Connect ACO,LLC
Health Connect Partners, LLC
Health Point ACO, LLC
Healthcare Partners of the North Country, llc
Healthcare Provider ACO, Inc.
HHC ACO Inc
HNMC Hospital/Physician ACO, LLC
Holy Cross Physician Partners ACO, LLC
Huntington Care Network ACO, LLC
Illinois Health Partners ACO, LLC
Illinois Rural Community Care Organization LLC
Independent Physicians' ACO of Chicago LLC
Independent San Diego ACO
Indiana Care Organization LLC
Indiana Lakes ACO
Indiana University Health ACO, Inc.
Ingalls Care Network, LLC
Innovative Health Alliance of New York, LLC
Inspira Care Connect, LLC
Integra Community Care Network LLC
Integral Healthcare, LLC
Integrated ACO LLC
Integrated Care Alliance, LLC
Integrated Medical Staff of Jackson, P.C.
Integrity Health Innovations, LLC
Jackson Purchase Medical Associates, PSC
JFK Population Health Company, LLC
John C. Lincoln Accountable Care Organization, LLC
John Muir Health Medicare ACO
Johns Hopkins Medicine Alliance for Patients, LLC
Kansas Primary Care Alliance, LLC
KentuckyOne Health Partners, LLC
Keystone Clinical Partners, LLC
Lahey Clinical Performance Accountable Care Organization, LLC
Lancaster General Health Community Care Collaborative, LLC
Lehigh Valley Health Network Accountable Care Organization, LLC
LHS Health Network, LLC
LifeBridge Health ACO, LLC
Live Oak Care
Loudoun Medical Group ACO LLC
Louisiana Physicians ACO LLC
Lower Shore ACO, LLC
Loyola Physician Partners ACO, LLC
Maine Community Accountable Care Organization, LLC
MaineHealth Accountable Care Organization
Mary Washington Health Alliance, LLC.
Maryland Accountable Care Organization of Eastern Shore LLC
Maryland Accountable Care Organization of Western MD LLC
Maryland Collaborative Care, LLC.
MBA - Northern California Physicians Management Group
MCM Accountable Care Organization, LLC
MD Valuecare, LLC
Medical Mall ACO
Medical Practitioners For Affordable Care, LLC
Medicare Value Partners
Memorial Hermann Accountable Care Organization
Mercy ACO, LLC (AR, MO)
Mercy ACO, LLC (IA)
Mercy Health ACO, LLC
Mercy Health Select, LLC
Mercy Health System ACO
Mercy-CR/UI Health Care Accountable Care Organization
Meridian Accountable Care Organization, LLC
Meridian Health Systems ACO Corporation
Meritage ACO, LLC
Methodist Patient Centered ACO
MetroHealth Care Partners
Mid-Atlantic Primary Care ACO
Midwest Health Coalition ACO
Millennium Accountable Care Organization
Mission Health Care Network, LLC
Mission Health Partners, Inc.
MissionPoint Birmingham, LLC
MissionPoint Evansville, LLC
MissionPoint Health Partners
MissionPoint Indianapolis, LLC
Morehouse Choice ACO-ES
Mount Sinai Care, LLC
MPS ACO Physicians, LLC
MyHealth First Network, LLC
National ACO, LLC
National Rural ACO
National Rural ACO II LLC
Nature Coast ACO LLC
NEPA ACO Company, LLC
NEQCA Accountable Care, Inc.
Nevada Primary Care Network, ACO, LLC
New Health Collaborative
New York State Elite (NYSE) Accountable Care Organization (ACO) Inc
NewYork Quality Care
NH Accountable Care Partners
NJ Physicians ACO
NOMS ACO, LLC
North Bend Medical Center, Inc.
North Central Arizona Accountable Care, LLC
North Coast Medical ACO, Inc.
North Collaborative Care
North Country ACO
Northeast Medical Group ACO, LLC
Northern Maryland Collaborative Care LLC
Northern Michigan Health Network
Northwest Ohio ACO, LLC
Northwest Rural ACO
Oakwood Accountable Care Organization, LLC
Ochsner Accountable Care Network, LLC
Oklahoma Health Initiatives
OneCare Vermont Accountable Care Organization, LLC
Optimus Healthcare Partners, LLC
Orange Accountable Care
Orange Accountable Care of New York
Orange Accountable Care of South Florida, LLC
Palm Beach Accountable Care Organization, LLC
Paradigm ACO, LLC
Partners in Care
Partners In Care ACO, Inc.
Penn State Health Care Partners
Physician Alliance of Kansas, Inc.
Physician Collaborative of Kansas City LLC
Physician Direct Accountable Care Organization
Physician First ACO
Physician Health Partners, LLC
Physicians Accountable Care of Utah
Physicians Accountable Care Organization, LLC
Physicians Accountable Care Solutions, LLC
Physicians ACO, LLC
Physicians Collaborative Trust ACO LLC
Physicians Collaborative Trust of the Mississippi Gulf Coast, LLC
Physicians Healthcare Collaborative, LLC
Physicians of Cape Cod ACO, Inc.
Pioneer Health Alliance
Pioneer Valley Accountable Care, LLC
PQN - Central Texas, LLC
Premier ACO Physician Network, LLC
Premier Care Network LLC
Premier Choice ACO, Inc.
Premier Patient Healthcare, LLC
PremierMD ACO, LLC
Pricare ACO, LLC
Primary Care Alliance LLC
Primary Comprehensive Care ACO LLC
Primary PartnerCare Associates IPA, Inc.
Primary Partners, LLC
Privia Quality Network, LLC
ProHEALTH Accountable Care Medical Group, PLLC
ProHealth Physicians ACO, LLC
ProHealth Solutions, LLC
ProMedica Physician Group, Inc.
Quality Health Alliance-ACO LLC
Quality Independent Physicians, LLC
Qualuable Medical Professionals, LLC
R TotalHealth, LLC
Redwood Community Care Organization, LLC
Reliance ACO LLC
Reliance Health Network
RGV ACO Health Providers, LLC
RHS Regional Health Network, LLC
Richmond Quality, LLC
Rio Grande Valley Health Alliance, LLC
River Health ACO,LLC
Rochester General Health System ACO
RWJ Partners LLC
Saint Francis HealthCare Partners ACO Inc.
Saint Vincent Accountable Health Network
Scott & White Healthcare Walgreens Well Network, LLC
Scottsdale Health Partners
Seton Accountable Care Organization, Inc.
Silver State ACO LLC
SLPA ACO, LLC
South Bend Clinic Accountable Care
South Florida Accountable Care Organization,LLC
Southcoast Accountable Care Organization, LLC
Southern Kentucky Health Care Alliance
Southern Maryland Collaborative Care LLC
Springfield Clinic ACO, LLC
SSM ACO, LLC
SSMOK ACO, LLC
St Joseph Health Partners ACO
St Vincents Accountable Care Organization LLC
St. Francis Accountable Health Network
St. Luke's Clinic Coordinated Care, Ltd.
St. Thomas Medical Group PLLC
Suburban Health ACO
Summit Health Solutions
Sunshine ACO LLC
SW Provider Partners LLC
Texoma ACO, LLC
The Accountable Care Organization, Ltd.
The Health Network of Western Kentucky, LLC
The Premier HealthCare Network LLC
THP-Meritus ACO, LLC
Tidewater Accountable Care Organization, LLC
Torrance Memorial Integrated Physicians, LLC
Triad HealthCare Network
Trinity Health Michigan d/b/a St. Mary Mercy Hospital
UCLA Faculty Practice Group
UMASS Memorial Accountable Care Organization, INC.
UnityPoint Health Partners
University Hospitals Coordinated Care Organization
UPSA ACO LLC
USMD Physician Services
USMM Accountable Care Partners, LLC
UT Southwestern Accountable Care Network
UW Health ACO, Inc.
Via Christi Health Alliance in Accountable Care, Inc.
Virginia Collaborative Care, LLC.
WakeMed Key Community Care, LLC
Wellmont Integrated Network
WellSpan Population Health Services
WellStar Health Network, LLC
West Florida ACO, LLC
West Tennessee Clinical Partners
Western Maryland Physician Network, LLC
WESTMED Medical Group, P.C.
Winchester Community ACO
Yavapai Accountable Care, LLC
Yuma Connected Community
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HHS seeks to have 85 percent of Medicare fee-for-service payments in value-based purchasing categories 2 through 4 by 2016 and 90 percent by 2018
Improving the quality and affordability of care for all Americans has always been a pillar of the Affordable Care Act, alongside expanding access to such care. The law gives us the opportunity to shape the way health care is delivered to patients and to improve the quality of care system-wide while helping to reduce the growth of health care costs.
When it comes to improving the way providers are paid, we want to reward value and care coordination – rather than volume and care duplication. In partnership with the private sector, the Department of Health and Human Services (HHS) is testing and expanding new health care payment models that can improve health care quality and reduce its cost.