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Understanding CMS Health Equity Framework | Priority One

CMS released a Framework for Health Equity 2022–2032, signaling a proactive approach to understanding and addressing the influence of social determinants of health (SDoH). This initiative aims to evaluate the impact of SDoH and formulate a strategic plan for individuals facing obstacles in accessing healthcare services. The CMS Health Equity framework calls upon all stakeholders...
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ACO REACH Blueprint – Strategies for Quality, Coordination, and Success

By Fauzia Khan, MD & CMO Persivia Inc. The ACO REACH (Accountable Care Organization Resources for Enhancing Services and Coordination) program is designed to support accountable care organizations (ACOs) in improving healthcare delivery, coordination, and outcomes for Medicare beneficiaries. Let’s analyze some key aspects of the program and discuss how a healthcare organization can succeed...
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CMS HCC-V28 is here! Are you prepared to navigate the regulatory changes in Risk Adjustment?

In the ever-changing realm of healthcare, the notion of value-based care (VBC) has gained substantial traction. At the core of this transformation lies risk adjustment – an essential element that ensures fairness and accuracy in reimbursement within VBC contracts. Our recent podcast episode titled “Navigating the Regulatory Seas: V28 Vs V24 | Risk Adjustment Ep...
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Understanding the Transition from V24 to V28 for Medicare Advantage HCC Coding

The Medicare Advantage 2024 Advance Notice introduces important modifications to HCC codes, disease mappings, and disease coefficient values, resulting in an impact on RAF scores for Medical Advantage Organizations! On March 31, 2023, HHS announced their final rule on 2024 Medicare Advantage Rate Change which included significant changes to the Medicare Risk Adjustment Model (named...
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Persivia CareSpace® and SDOH Data Integration

Persivia, a leading population health vendor, offers an innovative approach for SDOH Data integration into value-based care models. Persivia CareSpace® platform enables healthcare organizations to collect, analyze, and leverage SDOH data to deliver personalized and equitable care. Here are some key features and benefits of using Persivia’s technology. Data Collection and Aggregation Persivia’s platform facilitates...
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Leveraging SDOH Data to Improve Health Equity in Value-Based Care

In the transition from fee-for-service to value-based care (VBC) models, addressing health equity has become a crucial goal. The focus is shifting from providing equal care to providing equitable care, recognizing that different populations have unique needs. Incorporating social determinants of health (SDOH) data into VBC initiatives can help identify disparities and drive action towards...
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Operationalizing SDOH Data for Improved Patient Outcomes

In today’s healthcare landscape, Social Determinants of Health (SDOH) data plays a crucial role in understanding and addressing the broader factors that influence individual and population health. By capturing and operationalizing SDOH data effectively, healthcare organizations can unlock valuable insights that lead to better patient outcomes. This blog post will explore key strategies for operationalizing...
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Understanding the Game-Changing MSSP Rule Changes in the 2023 Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) recently published the 2023 Medicare Physician Fee Schedule Final Rule, introducing significant rule changes for the Medicare Shared Savings Program (MSSP). These changes have the potential to reshape the accountable care organization (ACO) landscape and drive substantial impact on healthcare providers. In this blog post, we’ll explore...
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The Importance of Risk Adjustment in Value-Based Care

The shift from fee-for-service to value-based care has revolutionized the healthcare industry, emphasizing the delivery of high-quality care rather than the quantity of services provided. As healthcare providers transition to this new model, risk adjustment plays a vital role in ensuring accurate measurement and compensation for performance. In this blog post, we will explore the...
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What is Value-Based Care and why does it matter?

Value-based care is a healthcare delivery model that focuses on achieving better patient outcomes while controlling costs. In this approach, the reimbursement for healthcare providers is tied to the quality and effectiveness of the care they deliver, rather than simply the quantity of services provided. The goal is to incentivize healthcare organizations and professionals to...
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