Accountable Care
An individual diabetes patient can expect to pay about $9,600 each year on diabetes medical costs alone.
CMMI is expected to release fewer, but bigger payment models and more that are mandatory.
Negotiations of drug prices are to be based on clinical outcomes; if the drug is not effective, the payer is not held accountable for the full price.
The initiative was born out of a realization that the health system needed to do more to improve outcomes and eliminate health disparities.
Although people aged 65 years and older make up more than 80% of deaths caused by COVID-19, younger adults make up the largest portion of cases.
Amarillo Legacy Medical ACO made that savings in just one quarter. If that trend continues, it's on track for a bonus.
The payments are in addition to the $15 billion already given to nursing homes in the targeted and general distributions of the Provider Relief Fund.
Direct contracting is the next CMMI model and is based on Next Generation, Medicare Shared Savings and Medicare Advantage plans.
Financial wellbeing depends on earning a patient's loyalty for life, says VP of business innovation and development.
Some 77% of Medicare beneficiaries who enroll in Medicare Advantage plans with drug coverage will be in plans with 4 or more stars.