About Validate Health
Get insights on CMS regulations, trends in Value Based Care, and other info to optimize the financial outcomes of your ACO.
National study on specialist engagement
National study on specialist engagement: We are kicking off a national study that would guide best practices around specialist engagement, specifically as it relates to the success of your ACO. This topic is a source of much debate and uncertainty, coming up every year across NAACOS discussions and our clients. The study seeks to leverage our ACO-specific national data assets to develop guidance for specialist provider topics: Incentive compensation, program overlap, QPP revenue, and referrals.
Using Your PY 2022 MSSP Settlement for PY 2024 Decisions
This webinar will help you interpret your settlement report and learn how to leverage for decisions: frequently asked questions, surprises about national trends, and examples of settlement calculations. Since there is still time to make selections for PY 2024 (due September 5th), the webinar will dive into considerations for the decisions remaining: dropping participants, early renewal, track selection, assignment methodology, and MSR/MLR.
New V28 CMS-HCC model may impact 2023 ACO priorities and 2024 decisions
New V28 CMS-HCC model may impact 2023 ACO priorities [...]
Multi-million dollar opportunities (and risks) with PY 2024 decisions
Multi-million dollar opportunities (and risks) with PY 2024 decisions [...]
Impact of (final rule) 2023 Medicare Physician Fee Schedule on your ACO’s financial decisions
Impact of (final rule) 2023 Medicare Physician Fee Schedule [...]
Webinar – What can still be done to impact 2022 shared savings
Webinar - What can still be done to impact [...]
Webinar – Using Your PY 2021 Settlement for PY 2023 Selections by Sept 9th
Webinar - Using Your PY 2021 Settlement for PY [...]
Helping ACOs Decide between ACO REACH and MSSP in 2023
Helping ACOs Decide between ACO REACH and MSSP in [...]
PY 2023 Decisions for Competing with or Participating in Multi-ACO Enabler Entities
PY 2023 Decisions for Competing with or Participating in [...]
Webinar – Last chance to decide between MSSP and REACH
Webinar -Last chance to decide between MSSP and REACH [...]
Webinar – Financial Changes in the Proposed 2023 Medicare Physician Fee Schedule
Webinar - Financial Changes in the Proposed 2023 Medicare [...]
PY 2023 decisions for ACOs Webinar Series
PY 2023 decisions for ACOs: Webinar Series Validate [...]
Implications of Plummeting National Risk Scores for Your ACO’s 2021 Shared Savings Settlement
Implications of Plummeting National Risk Scores for Your ACO’s [...]
Whitepaper – Correcting Your ACO’s Preliminary Benchmark Report Before Making 2023 Model and Track Selection
Whitepaper: Correcting Your ACO’s Preliminary Benchmark Report Before Selecting [...]
Webinar – Optimizing 2023 Model & Participant Selection
Webinar - Optimizing 2023 Model & Participant Selection (2022-04-06) [...]
Webinar 3 of 3 – Calculating accurate and fair shared savings contribution by provider with CMS’s 2020 COVID rule changes
Webinar 3 of 3 - Calculating accurate and fair [...]
Webinar 2 of 3 – What can still be done to impact 2021 shared savings
Webinar 2 of 3 - What can still be [...]
Webinar 1 of 3 – How to use your 2020 MSSP settlement to make 2022 decisions by Sept 10 deadlines
Webinar 1 of 3 - How to use your 2020 [...]
ACO Participant and Track Selection: Using TIN-Level Metrics to Make ACO-Level Decisions
With the Shared Savings Contribution approach, financial impact of practices that implemented care management workflows becomes evident, with the more engaged practices rewarded accordingly. Positive contributing physicians subsidized those who lowered the shared savings of the ACO. Example cases demonstrate potential far-reaching consequences of distribution strategy on long term sustainability of an ACO.
Targeted HCC Risk Coding Investment Based on Calculated ROI of Gap Closure
Risk scores are an extremely important piece of the MSSP shared savings formula. Despite this, risk scoring rarely gets the attention it deserves. That’s because optimizing risk scores can be much more That’s because the how, when, and whys of investing into risk scoring can have complicated answers. In this article we cover all the basics on effectively investing to increase risk scores.
Impact of the COVID-19 Pandemic on ACO Financials Under MSSP
While CMS exemption of COVID-19 related inpatient expenditures may decrease spending for ACOs, deferred care and outpatient costs associated with COVID-19 may still drive up expenses, leading to financial losses. In response, Validate has added to their services to include COVID-19 episode exclusions for more accurate updated benchmark calculations, risk score monitoring for optimal adjustment to the historical benchmark, beneficiary assignment adjustment for telehealth inclusion, and COVID-19 adjusted analytics.
Expanding Your Organization’s Network
If you’re not focusing on your provider selection in a fast changing VBC market, your organization is falling behind. Whether you are a small ACO, new to taking on financial risk, or a large and profitable ACO eyeing new opportunities, your strategy should include evaluating your provider selection and expanding your organization’s network.
Beneficiary Attribution Management
Having a beneficiary attribution management strategy is essential to identifying beneficiaries at risk of de-attribution and to opening doors for the attribution of additional beneficiaries. It also helps to avoid unintended attributions, which can be costly.
ACO Performance Forecasting Overview
ACOs often stand to benefit from moving to greater downside risk. However, this move is difficult to undertake if ACOs aren’t yet sure of their success in the prior year. Having a more accurate performance forecast in hand would allow successful ACOs to move confidently into greater risk (and reward) tracks.
Provider Compensation
Understanding the specifics of an ACO contract’s attribution methodology and the nuances that vary from contract to contract is key to ACO strategy and success.
Track Selection & Risk Readiness
Being able to explain track decisions to providers, investors, and other health system leaders strengthens the position of ACO leadership and sets up the organization for success.
Impact of the 2018 National Assignable Trend Factor on ACO Financials
Most ACOs do not use a sufficiently accurate national assignable trend factor. Even after recognizing the impact of national trend on shared savings, it is important to recognize that it’s still one of many inputs impacting shared savings. ACOs can improve their financials and mitigate risk exposure by proactively managing these inputs through multi-year scenario simulations.
Evaluation of Potential ACO Performance Bias from Retrospective and Prospective Assignment
This is the first study to simulate the prospectively and retrospectively assigned beneficiary populations for actual ACOs. Key metrics were evaluated for each of the 322 ACOs during the 2015 performance year. Despite significant differences between prospective and retrospective assignment, neither methodology shows performance bias.
The Importance of Calculating Shared Savings/Loss Contribution by Provider
With the Shared Savings Contribution approach, financial impact of practices that implemented care management workflows becomes evident, with the more engaged practices rewarded accordingly. Positive contributing physicians subsidized those who lowered the shared savings of the ACO. Example cases demonstrate potential far-reaching consequences of distribution strategy on long term sustainability of an ACO.