Center for Medicare and Medicaid Innovation

Aledade Saved Medicare More Than $572 Million In 2022

Retrieved on: 
Wednesday, September 20, 2023
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In addition to being the largest network of independent primary care in the country, Aledade also had the most successful accountable care organizations (ACO) in the country.

Key Points: 
  • In addition to being the largest network of independent primary care in the country, Aledade also had the most successful accountable care organizations (ACO) in the country.
  • Practices in Aledade ACOs earned $294 per Medicare beneficiary - roughly double the average hospital-led ACO savings of $140 per Medicare beneficiary across the MSSP.
  • That means the average-sized primary care practice working with Aledade earned $218,219 in shared savings payments for providing more proactive, preventive primary care in 2022.
  • Mississippi practices working with Aledade led the nation in providing Annual Wellness Visits to their patients and earned shared savings payments of more than $26 million.

WellSpan Health ACO earns high performance, savings under Medicare Shared Savings Program

Retrieved on: 
Monday, September 18, 2023
ACO, CMS, South Central Pennsylvania, Centers for Medicare & Medicaid Services, Accountable care organization, WellSpan Health, Center for Medicare and Medicaid Innovation, Acos, Medicare, Patient, Physician, Health, Health insurance

York, Pa., Sept. 18, 2023 (GLOBE NEWSWIRE) -- WellSpan Health’s Medicare Accountable Care Organization (ACO) is a leader in value-based care and is the largest ACO in South Central Pennsylvania.

Key Points: 
  • York, Pa., Sept. 18, 2023 (GLOBE NEWSWIRE) -- WellSpan Health’s Medicare Accountable Care Organization (ACO) is a leader in value-based care and is the largest ACO in South Central Pennsylvania.
  • As a participant in the Medicare Shared Savings Program, WellSpan and our independent practice partners improved quality, experience and affordability to its more than 51,000 beneficiaries across South Central Pennsylvania, according to recently released data from the Centers for Medicare and Medicaid Services (CMS).
  • Health systems, independent physician groups and others oversee improvements in access to quality care, enhance care coordination and manage chronic conditions.
  • As part of creating a better care delivery system, Medicare rewards ACOs who provide higher quality care at a more affordable cost by sharing in the savings it achieves for the Medicare Program.

MHN ACO Announces Yasin Patel as New President & CEO

Retrieved on: 
Wednesday, September 20, 2023
Health, Hospitals, Health Technology, Other Health, Health Insurance, Managed Care, ACO, Medicaid, MHN, Health equity, CMMI, Multimedia, Organization, Medicare, Chicago, Hospital, MD, Patient, Center for Medicare and Medicaid Innovation, Management, Nursing

The MHN Accountable Care Organization (MHN ACO, LLC), a network made up of 16 Cook County non-profit provider organizations, announced today Yasin Patel will serve as president and CEO of the organization.

Key Points: 
  • The MHN Accountable Care Organization (MHN ACO, LLC), a network made up of 16 Cook County non-profit provider organizations, announced today Yasin Patel will serve as president and CEO of the organization.
  • View the full release here: https://www.businesswire.com/news/home/20230920389465/en/
    Yasin Patel, president and CEO of MHN ACO.
  • As the president and CEO, Patel will work closely with long-time partner Medical Home Network, which founded the MHN ACO in 2014 and recently renewed its management services agreement to provide care enablement services for the ACO.
  • “I’m excited to join MHN ACO and work with a team that shares my passion for furthering health equity and reducing disparities in care,” Patel said.

National transplant patient and physician groups ask President Joe Biden and HHS Secretary Xavier Becerra to: "Stop private contractors from rolling back Medicare coverage of non-invasive blood tests to detect transplant rejection"

Retrieved on: 
Thursday, September 21, 2023
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WASHINGTON, Sept. 21, 2023 /PRNewswire/ -- Honor the Gift, a coalition representing organ transplant patients across the nation, along with other allied leaders across the transplant field, held a press conference, calling on President Joseph R. Biden and Health and Human Services (HHS) Secretary Xavier Becerra to stop the current attempt by private contractors to rollback Medicare coverage of safe, non-invasive molecular blood tests that can allow for the early detection of organ rejection.

Key Points: 
  • -- Paul Conway, AAKP
    Medicare coverage for these innovative blood tests became available for transplant patients starting in 2006, with coverage expanding in 20171.
  • The alternative for such blood tests is surgical biopsy procedures, which are more expensive, riskier, and burdensome.
  • See statements from American Society for Transplant Surgeons , American Society of Transplantation , and The International Society for Heart and Lung Transplantation .
  • This billing article was issued without allowing for public comment, including comments from the transplant patients who would be impacted.

Scipher Medicine Receives Medicare Coverage for PrismRA® Test in Rheumatoid Arthritis Patients

Retrieved on: 
Thursday, September 7, 2023
Other Health, Software, Managed Care, Pharmaceutical, Oncology, White House, Federal Government, Medical Devices, Technology, Health Insurance, Biotechnology, Health, Public Policy, Government, CMS, RA, Failure, Centers for Medicare & Medicaid Services, LCD, Medicare, MAC, Center for Medicare and Medicaid Innovation, Patient, Medicine, Rheumatoid arthritis, Pharmaceutical industry

Scipher Medicine Corporation, a precision immunology company matching each patient with their most effective therapy, today announced that Palmetto GBA, a Medicare Administrative Contractor (MAC), and Centers for Medicare and Medicaid Services (CMS) published a local coverage determination (LCD) for molecular biomarker testing to guide targeted therapy selection in rheumatoid arthritis (RA) patients.

Key Points: 
  • Scipher Medicine Corporation, a precision immunology company matching each patient with their most effective therapy, today announced that Palmetto GBA, a Medicare Administrative Contractor (MAC), and Centers for Medicare and Medicaid Services (CMS) published a local coverage determination (LCD) for molecular biomarker testing to guide targeted therapy selection in rheumatoid arthritis (RA) patients.
  • The coverage decision includes PrismRA, Scipher’s innovative molecular diagnostic test that guides treatment selection for patients with RA.
  • “Precision medicine will now be accessible to many patients suffering from rheumatoid arthritis, a potentially debilitating disease if not treated with the right therapy,” Scipher Medicine CEO Alif Saleh said.
  • “This coverage decision not only represents a significant benefit for patients today but also ushers in a new era of precision medicine in autoimmune diseases.”
    Access to PrismRA will benefit eligible patients within Medicare who covers approximately 66 million lives in the United States.

Alignment Healthcare Welcomes New Chief Medical Officer

Retrieved on: 
Wednesday, September 6, 2023
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ORANGE, Calif., Sept. 06, 2023 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC) today announced the return of Dr. Hyong (Ken) Kim, as its chief medical officer (CMO) effective Sept. 25.

Key Points: 
  • ORANGE, Calif., Sept. 06, 2023 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC) today announced the return of Dr. Hyong (Ken) Kim, as its chief medical officer (CMO) effective Sept. 25.
  • Dr. Kim played an integral role in Alignment’s founding and, from 2013 to 2018, served as CMO of Alignment Healthcare, where he co-developed, built and managed Alignment’s clinical operations team.
  • “With his intimate knowledge of Alignment, his track record of success and his unique policy perspective, we are confident Ken will help us continue to scale and champion a new path in senior care.”
    Most recently, Dr. Kim served as Chief Clinical Officer at CareConnect MD.
  • Before helping found Alignment, he was one of the clinical leaders at CareMore Health, ultimately serving as CMO from 2009 to 2013.

Deborah Earns 4 out of 5 CMS Stars for Experience and Overall Quality

Retrieved on: 
Wednesday, September 6, 2023
COPD, Heart, CMS, Centers for Medicare & Medicaid Services, Friends, Society of Thoracic Surgeons, Patient satisfaction, System, Health care, Center for Medicare and Medicaid Innovation, Research, Multimedia, Lung, U.S. News & World Report, Medicare, Deborah Heart and Lung Center, Hospital, Patient, TAVR, Heart failure, LVAD, Diagnosis, Health, Family, News

BROWNS MILLS, N.J., Sept. 6, 2023 /PRNewswire/ -- One of only two hospitals "most likely to be recommended in New Jersey." That's a new quality indicator Deborah earned from the Centers for Medicare and Medicaid Services (CMS) annual Hospital Consumer Assessment of Healthcare Providers and Systems. Ratings are based on patients' responses to the question, "would you recommend this hospital to your friends and family." 

Key Points: 
  • That's a new quality indicator Deborah earned from the Centers for Medicare and Medicaid Services (CMS) annual Hospital Consumer Assessment of Healthcare Providers and Systems.
  • Ratings are based on patients' responses to the question, "would you recommend this hospital to your friends and family."
  • Deborah was also one of only four hospitals in New Jersey to earn 4 out of 5 Stars by CMS in its annual Hospital Quality Star Ratings annual update, which summarizes data from 46 existing measures for each hospital.
  • Founded in 1922, Deborah has treated more than 2.3 million hearts from every corner of the United States and 87 countries.

Gamida Cell Reports Second Quarter and First Half 2023 Financial Results and Provides Company Update

Retrieved on: 
Monday, August 14, 2023
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(Nasdaq: GMDA), a cell therapy pioneer working to turn cells into powerful therapeutics, today provided a business update and reported financial results for the quarter ended June 30, 2023.

Key Points: 
  • (Nasdaq: GMDA), a cell therapy pioneer working to turn cells into powerful therapeutics, today provided a business update and reported financial results for the quarter ended June 30, 2023.
  • “Since the approval of Omisirge in April, Gamida Cell has made excellent progress on the launch,” said Abbey Jenkins, President and Chief Executive Officer of Gamida Cell.
  • Terry Coelho, MBA, appointed Chief Financial Officer: In May 2023, Gamida Cell announced the appointment of Terry Coelho as Chief Financial Officer.
  • Commercial expenses were $3.9 million in the second quarter of 2023, compared to $3.2 million in the second quarter of 2022.

CareBridge Named Fastest Growing Private Healthcare Company in America

Retrieved on: 
Tuesday, August 15, 2023
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NASHVILLE, Tenn., Aug. 15, 2023 /PRNewswire/ -- CareBridge, the nation's leading Medicaid value-based care company, today announces it was ranked No. 1 on Inc. Magazine's prestigious Inc. 5000 list of the fastest growing, privately owned companies in America. CareBridge is the first healthcare company in a decade to be ranked No. 1 on the list. 

Key Points: 
  • First Healthcare Company in a Decade to be Ranked #1 on Inc. 5000 List
    NASHVILLE, Tenn., Aug. 15, 2023 /PRNewswire/ -- CareBridge, the nation's leading Medicaid value-based care company, today announces it was ranked No.
  • 1 on Inc. Magazine's prestigious Inc. 5000 list of the fastest growing, privately owned companies in America.
  • CareBridge is the first healthcare company in a decade to be ranked No.
  • CareBridge is the second company CareBridge Founder and Executive Chairman Brad Smith has had on the Inc. 500 list.

Athletico Physical Therapy Recognized for Providing Exceptional Patient Care by CMS

Retrieved on: 
Monday, August 14, 2023
CMS, Population health, Centers for Medicare & Medicaid Services, OAK, Athletico Physical Therapy, PT, Occupational therapy, Medicare, Patient, MIPS, Clinical Systems and Networks, Health, Center for Medicare and Medicaid Innovation, Pharmaceutical industry, Atlético

OAK BROOK, Ill., Aug. 14, 2023 /PRNewswire/ -- Athletico Physical Therapy, a leading provider of outpatient physical and occupational therapy services, has again been ranked as a top-tier provider by the Center for Medicare and Medicaid Services' (CMS) for excellence in patient care in 2022. Athletico clinicians voluntarily participated in the annual CMS Quality Payment Program, achieving "Exceptional" scores for their commitment to quality outcomes and cost-effective care under the Merit-Based Incentive Payment System (MIPS). This marks Athletico's fourth consecutive year as a top-tier performer.

Key Points: 
  • OAK BROOK, Ill., Aug. 14, 2023 /PRNewswire/ -- Athletico Physical Therapy, a leading provider of outpatient physical and occupational therapy services, has again been ranked as a top-tier provider by the Center for Medicare and Medicaid Services' (CMS) for excellence in patient care in 2022.
  • Athletico clinicians voluntarily participated in the annual CMS Quality Payment Program, achieving "Exceptional" scores for their commitment to quality outcomes and cost-effective care under the Merit-Based Incentive Payment System (MIPS).
  • "Athletico has a strong reputation for delivering high-quality musculoskeletal services and exceptional patient care.
  • "We firmly believe that physical and occupational therapy services are on the right side of the value curve for mitigating musculoskeletal care costs.