Author: Mohan Gounder
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Medicare Issues Request for Information related to Urgent Care Reimbursement
The Center for Medicare and Medicaid Services (CMS) issued a request for information related to Urgent Care reimbursement. The exact text from the 2025 proposed Medicare Physician Fee Schedule is here: https://public-inspection.federalregister.gov/2024-14828.pdf (pages 390 to 391): “We’ve received information from interested parties that there is a similar concern regarding urgent care centers more broadly. These…
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Innovative “PC Flex” Model
The ACO Primary Care Flex Model (PC Flex Model) is a new initiative by the Centers for Medicare & Medicaid Services (CMS) designed to support primary care within low revenue Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. UACO is applying to be the only urgent care-focused ACO to test the benefits…
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ACO Quality Measurement
The “Quality Performance Standards” section of the Medicare Shared Savings Program (MSSP) outlines the requirements that Accountable Care Organizations (ACOs) must meet to qualify for shared savings. These standards are designed to ensure that ACOs deliver high-quality care to their beneficiaries while also achieving cost savings. Here are the key components of the Quality Performance…
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MSSP Fundamentals
An Accountable Care Organization (ACO) is a group of healthcare providers, such as doctors, hospitals, and other healthcare professionals, who voluntarily come together to provide coordinated, high-quality care to their Medicare patients. The primary goal of an ACO is to ensure that patients, especially those with chronic conditions, receive the right care at the right…