Blog

In Terms of Care Delivery and Care Coordination, The ACO REACH Model will benefit both Recipients and Providers

Even though the Social Determinants of Health (SDoH) and health equity have received a great deal of interest from the healthcare industry in the recent years, the Biden administration is overhauling the contentious Direct Contracting Model to include additional conditions aimed at addressing the health equity model of accountable care and assuaging progressive legislators’ worries...
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ACO REACH Model’s Strategic Ramifications in the Healthcare Industry

The Centers for Medicare and Medicaid Services (CMS) Innovation Center is working on replacing its Global and Professional Direct Contracting model (GPDC), which will be phasing out at the end of 2022, with the highly-anticipated Accountable Care Organization Realizing Equity, Access, and Community Health model (ACO REACH), which will take effect on January 1, 2023....
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The Financial Benefits of the Primary Care First Model for Practices

Primary Care First (PCF) intends to increase primary care professionals’ self-governance by providing more operational adaptability and performance-based incentives, allowing them to customize care delivery depending on their specific patient groups and resources. The concept actively encourages providers to invest additional time with patients and offer coordinated, effective care by connecting health outcomes for patients...
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Primary Care First: A Quick Overview

There Are A few Things You Should Be Aware of About Primary Care First Primary Care First (PCF), innovative care delivery and reimbursement paradigm designed by the CMS Innovation Center is a distinct method for improving primary care. PCF criteria and the care delivery model are similar to the Comprehensive Primary Care Plus (CPC+) framework...
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Successfully Implementing AI Solutions for A 100% Encounter Data Reality

As CMS moves towards 100% encounter data in risk adjustment calculations next year, the ability to extract relevant information from clinical records will become paramount. While payers dread this upcoming change in Medicare Advantage and Part D calculations, all is not lost. In this article, we will identify a few key innovations these organizations can...
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Accountable Care: Key Changes in CJR Program for a Smooth Transition towards Performance Year 6

Introduced back in 2016, the Comprehensive Care for Joint Replacement (CJR) program was designed to bundle payments for joint replacement surgeries in acute care hospitals and hold them financially accountable for the episode of care. COVID-19: Something that Caught Everyone off Guard Initially, the CJR program was planned to go for 5 years. However, the...
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A New ERA in CMS Quality Data Submissions – 2021

ACO’s that have been relying on the comfort of submitting CMS Web Interface reports during the 2021 buffer year will no longer have that luxury come 2022 as CMS completely switches to the eCQM or MIPS CQM reporting model. This means that organizations must implement a technology that allows them to switch to an electronic...
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Reimagine Your Year-End Goals with an Unimaginable Offer!

Persivia, the leading provider of population health, risk management, and hybrid care management solutions is proud to announce that we will be offering our HCC Risk Adjustment module Absolutely FREE for any organization that signs up with us in Q4 of 2021.
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6 Things to Keep in Mind while searching for a QCDSM

The start of the CMS Appropriate Use Criteria (AUC) program is rapidly approaching. Beginning January 1, 2022, an AUC consults prior to ordering advanced diagnostic imaging for Medicare patients must be documented via a CMS-qualified clinical decision support mechanism (QCDSM). Without a documented consult, rendering providers will not receive Medicare payment for the procedure. To...
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Preparing for the 2022 CMS Appropriate Use Criteria Program Final Rule

2022 CMS Appropriate Use Criteria Program Final Rule is back, are you ready? See how radiologists can reap financial rewards.
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Appropriate Use Criteria Program & Its Impact on Radiologists

Persivia QCDSM helps you stay compliant with Appropriate Use Criteria Program AUC.
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