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At the beginning of this series, we laid out a basic tenet: As shared savings plan ACOs, you need to do as well or better at lowering costs than competing value-based payment models. Otherwise, your resources and support will dwindle in favor of more promising avenues to control Medicare spending, and competition will stifle your growth. We’ve examined the competition and what they offer physicians to succeed in Risk and to attract patients. The bar is high.
Fierce Healthcare | October 5, 2021

The Biden administration wants to move away from creating value-based care payment models for every type of disease, episode of care or specialty groups to streamline its projects, a top official said. Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler said during a briefing Tuesday hosted by the Alliance for Health Policy that more mandatory models are needed, including those that focus on the total cost of care.
UM is an important, systematic process that promotes efficiency in healthcare. 
When performing UM, care managers consider the following factors to determine the appropriateness of care for a member: The severity of symptoms, acuity of symptoms, prior treatment efforts, clinical diagnosis, and level of impairment in functioning. Clinical outcomes research and level of care guidelines. Capabilities of local providers and facilities. This ensures that members get appropriate and necessary care in the right setting without redundant or unnecessary procedures.
While the COVID-19 pandemic rages, the past two years have seen another epidemic of a far different type—in financing and acquisitions of firms focused on serving Medicare beneficiaries. These firms include physician practices, notably primary care practices (PCPs); management services organizations (MSOs) that aggregate practices; and Medicare Advantage (MA) insurers.
Sponsored Webinars

CCM & PCM: Netting Higher Patient Outcomes and Increased Financial Incentives
  • Topic: how to get the most out of Chronic Care Management and Principal Care Management services
Sponsored by: Salient Healthcare
October 20, 2021 | 1 PM EST

Leveraging App Developer Program to Create Seamless Member & Clinician Experiences Amidst a Digital Transformation
  • Topic: lessons from the App Developer Program community and a collaboration with CVS Health's nurse care management business, Accordant Health Services
Sponsored by: Mozzaz
October 27, 2021 | 1 PM EST


Working Capital Options for ACOs
  • Topic: options for working capital that are available to ACOs, including traditional bank financing, accounts receivable line of credit or equity investment

The True Story of How One Health System moved the Patient Experience Needle
  • Topic: how to use digital outreach strategies and technology to coordinate communication, increase member experience and satisfaction, and improve CAHPS scores
Sponsored by: HealthCrowd

Upcoming Conferences
FLAACOS Fall Conference
November 4-5, 2021 | Orlando, FL (Live & Virtual)

American Physician Groups Annual Conference
December 9-11, 2021 | San Diego, CA

Exhibitor Spotlight
BioReference Laboratories, Inc. is the largest full service specialty laboratory in the United States that delivers reliable, convenient and innovative diagnostic solutions tailored to the specific needs of healthcare providers, patients and organizations. BioReference is a trusted laboratory partner for ACOs and IPAs, with a vision to provide high quality, personalized diagnostics to all patients.
Platinum Level Exhibitors
Thank you to our Platinum Level exhibitors. These organizations offer the absolute highest quality products & services to the ACO & IPA community. To learn more & visit their interactive booths, click on the logos below:
Gold Level Exhibitors
Thank you to our Gold Level exhibitors. To learn more & visit their interactive booths, click on the logos below:
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