February 15, 2019
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Healthcare Dive | February 13, 2019 

  • CMS is launching a project to share Medicare claims data with accountable care organizations in bulk, Administrator Seema Verma announced Tuesday at HIMSS19 in Orlando, Florida.
  • The project, called the Beneficiary Claims Data API (BCDA), will allow ACOs participating in the Medicare Shared Savings Program to retrieve Part A, B and D claims data for their beneficiaries - including Medicare claims data from care received outside the ACO.
  • BCDA will provide this data to ACOs in a similar format to how CMS provides them with claims data, according to a website on the application programming interface.

Healthcare Innovation | February 7, 2019  
In the rush forward into alternative payment models, including accountable care organization (ACO)-based models, could primary care physicians be in the process of being progressively disadvantaged? A new analysis by a medical researcher suggests that such might be the case, at least when it comes to payment for evaluation and management (E&M) services. . . READ MORE    

HealthLeaders Media | February 13, 2019 
For the thousands of people attending the 2019 HIMSS conference this week, there is no escaping the buzz about the proposed new interoperability rules issued by the U.S. Department of Health and Human Services (HHS) on Monday. Centers for Medicare & Medicaid Services Administrator Seema Verma is the ubiquitous face of the news at the event, participating with a panel of representatives at the opening keynote session yesterday morning, and closing out the day with presentation about the latest news, along with a videotaped message from HHS Secretary Alex Azar. Verma also conducted a press conference yesterday for members of the media... READ MORE    

Tincture | February 10, 2019     
Starting in 2020, Medicare Advantage plans will be allowed to offer supplemental, "non-primarily health-related" benefits to help certain eligible chronically ill patients with unmet social needs. Put simply, this represents a large source of reimbursement for social determinants of health (SDOH) solutions in the high-growth MA market. . . READ MORE    

Vendor Spotlight

Most Medicare Shared Savings Program ACOs are unaware that CMS expects them to be generating at least 60% of their revenue through commercial contracts by year five of the organization's existence. Moreover, many Advanced Payment ACOs will find themselves in a tight spot once CMS seed money runs out unless commercial contracts are in place.  Reliance Consulting Group  works with ACOs all around the nation to establish lucrative contracts and value based care initiatives with major payers.
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