Providers Need to Engage in Payment Reform to Prevent Payment Reductions


KANSAS CITY, MO., February 21, 2019 - Caravan Health and Margaret Mary Health recently published a whitepaper exploring the effect of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on community hospitals. Health providers could face serious reductions in Medicare payment rates unless they engage in delivery system and payment reform efforts. Providers must make a plan to understand these new rules and avoid financial distress.

Our health care system is in a transition from fee-for-service to fee-for-value payment. In 2015, this transition took a big step forward with the passage of the Medicare Access and CHIP Reauthorization Act, which repealed the Sustainable Growth Rate formula for physician payment and established the Quality Payment Program (QPP). The QPP allows providers to participate in an alternative payment model (APM) which pays incentives for high quality and cost-ecient care. In short, APM participation maximizes Medicare reimbursement. More than half of providers nationwide are now participating in APM programs.

The new whitepaper explains that Medicare Shared Savings Program accountable care organizations (ACOs) are a prudent option for community health systems seeking to avoid payment reductions while maintaining quality of care. These ACOs are the most common type of APM, counting about one-third of fee-for-service patients, providers and hospitals in 2018. ACO participation works especially well for hospitals because they employ many of the nation’s physicians as well as nurses that can implement population health measures that have been shown to improve care quality.

“Caravan Health has found the key to, not just surviving, but thriving in this new world of value-based payment,” said Lynn Barr, Caravan Health CEO and Founder. “A Caravan Health Collaborative ACO brings independent health systems together to introduce new population health measures that lead to better patient care and financial success. An ACO with more covered lives leads to more predictable and sustainable results.”

“As part of a Caravan Health ACO, we are reaching the promise of value-based payment,” said Tim Putnam, President and CEO of Margaret Mary Health, a critical access hospital in Batesville, IN. “Since implementing new population health measures, the change in approach has been evident for our clinicians and patients. I truly believe it helps our patients lead more healthy lives.”

Download the whitepaper to learn more.
Caravan Health will also hold an interactive webinar to discuss options for community health systems. Join the discussion on February 28 at 10am PT/12pm CT/1pm ET. 

Register here

Recent Articles and News

March 11, 2020

WakeMed Joins Caravan Health Collaborative ACO for 2020

Value-based ACO improves quality, coordination of care for beneficiaries

ACO, News

January 29, 2020

Caravan Health Offers Rural Clients a Risk-Free ACO Solution

Today, Caravan Health announced a groundbreaking new Rural Risk-Free Solution to support rural health systems in the Medicare Shared Savings Program. By 2021, all ACOs in Medicare will be in the Pathways to Success Program, which requires paying back certain higher-than-expected Medicare costs during the agreement period.

ACO

December 12, 2019

Caravan Health to Host Webinar on Direct Contracting Model Opportunity

Caravan Policy and Compliance Officer LeeAnn Hastings and Policy Analyst Louise Yinug will review the details of this new risk-based alternative payment model, which will launch an implementation year in 2021.

Policy, CMS

newsletter signup

Stay Informed with our newsletter

Stay on top of the latest trends on accountable care, population health, and health care policy.

ACO insights delivered right to you

Thank you

Sign up for our newsletter of data-driven news and stories from the latest in ACOs, value-based care, and population health.

  • Real-time insight into alternative payment model trends
  • Strategies and practices that drive results
  • Leadership lessons from health care and beyond
  • Perspectives on the changing health care landscape

By sharing your email you agree to our Privacy Policy

newsletter signup