Sami Laurin

The Centers for Medicare & Medicaid Services (CMS) has finalized comprehensive changes to Medicare reimbursement for skin substitute products used in wound care. Effective January 1, 2026, the rule restructures Medicare Part B payment methodology across hospital outpatient and non-facility settings, shifting away from the traditional average sales price (ASP) model toward a standardized flat-rate […]

Healthcare is shifting from a fragmented, opaque system to one increasingly driven by empowered patients and data transparency. A recent Healthcare Dive article highlights how price and quality transparency is transforming the healthcare landscape and setting the stage for more competitive, patient-centered markets — trends that are highly relevant for primary care practices and ACO

There’s a seismic shift happening in healthcare. Traditional fee for service (FFS) models are underperforming, underfunding, and overburdening primary care. As Healthcare Dive reports, Medicare’s physician fee schedule structurally undervalues primary care while financially rewarding volume-driven specialty services (Healthcare Dive, 2024). For Primary Care Providers (PCPs), this is the moment to take control. The better

A new study published in JAMA Oncology offers strong real-world evidence that initiating colorectal cancer (CRC) screening with fecal immunochemical tests (FIT) between ages 40 and 49 can significantly reduce long-term cancer incidence and mortality. While this may seem outside the immediate scope of Medicare-focused Accountable Care Organizations (ACOs), the implications for preventive care strategy

Independent Physician Associations (IPAs) today are navigating one of the most complex landscapes in the history of modern healthcare. Between tightening regulatory changes, unpredictable Medicare Advantage dynamics, and shrinking margins, many IPA leaders are searching for new ways to stabilize revenue and drive sustainable growth. Medicare Advantage Headwinds and Risk Adjustment Pressures Medicare Advantage (MA)

In recent years, the cost of skin substitutes for wound care has skyrocketed, raising serious concerns for healthcare providers and Accountable Care Organizations (ACOs). The U.S. market for skin substitutes has grown from approximately $1 billion in 2019 to nearly $7 billion in 2024, fueled by questionable billing practices and inflated reimbursement rates. Advanced Management

The introduction of the Accountable Care Prospective Trend (ACPT) in the Medicare Shared Savings Program (MSSP) represents a major shift in how Accountable Care Organizations (ACOs) are benchmarked and incentivized. As a management company overseeing both prospective (REACH) and retrospective (MSSP) ACO models, Advanced Management USA is closely analyzing the implications of this change to

The recent wildfires sweeping through Southern California have led to significant closures of outpatient facilities in the region, causing disruptions in access to care for thousands of patients. Major health systems, including Kaiser Permanente, Providence, Cedars-Sinai, Adventist Health, and UCLA Health, have had to shut down clinics in affected areas, such as Santa Monica, Pasadena,

In today’s healthcare landscape, physicians face increasing challenges, including eroding trust in leadership and diminishing autonomy. A recent survey highlights these issues, with more than half of physicians doubting their leaders’ honesty and transparency, and only 47% trusting that leadership decisions benefit patients​. Amidst these concerns, Accountable Care Organizations (ACOs) offer a compelling path for

The landscape of quality reporting in the healthcare sector continues to evolve, with significant implications for Accountable Care Organizations (ACOs). For Performance Year (PY) 2024, three primary reporting methods are available: CMS Web Interface, Medicare Clinical Quality Measures (Medicare CQMs), and Electronic Clinical Quality Measures (eCQMs). Each option presents unique advantages and challenges, making it

Introduction As the healthcare landscape continues to shift towards value-based care, accountable care organizations (ACOs) play a pivotal role in reducing costs while ensuring quality patient outcomes. At Advanced Management USA, we specialize in supporting ACOs to maximize their impact in both areas. In 2023, our ACO partners achieved remarkable results in earned savings and

The Centers for Medicare & Medicaid Services (CMS) has set an ambitious goal: by 2030, all Medicare beneficiaries should be enrolled in value-based care arrangements. This initiative aims to move away from the traditional fee-for-service (FFS) model, steering towards a system that prioritizes quality and outcomes over volume. While the potential benefits of this transition

Introduction Hurricane season can be stressful, especially for primary care physicians (PCPs) who are responsible not only for their own safety but also for their patients. At Advanced Management USA, we know that when a storm is brewing, PCPs become a crucial lifeline for their patients. This means helping patients prepare for what’s coming while

At Advanced Management USA, we have always recognized the critical role of Accountable Care Organizations (ACOs) in driving value-based healthcare. As the healthcare landscape continues to shift, the significance of ACOs has only intensified. Initially formed to improve healthcare outcomes while controlling costs, ACOs now face an even more urgent mandate: delivering consistently high-quality care.

Promoting healthy lifestyles is a cornerstone of primary care, especially within Accountable Care Organizations (ACOs). As the focus shifts from treating illnesses to preventing them, primary care providers (PCPs) are uniquely positioned to lead this transformation. This article will explore the importance of lifestyle promotion in primary care, effective strategies, and how ACOs can support

Transitioning to a value-based care model can significantly enhance patient outcomes and streamline practice management. However, it requires a strategic approach and thoughtful adjustments. Here’s a comprehensive guide with actionable tips for physicians on optimizing their practices to thrive in a value-based care environment, focusing on patient management, care coordination, and performance tracking. Introduction Value-based

In recent years, the healthcare landscape has been evolving rapidly. One of the significant shifts has been the increased emphasis on quality care. There’s a common misconception that focusing on quality diminishes productivity and, subsequently, compensation. However, recent data suggests that prioritizing quality care can actually lead to enhanced productivity and higher physician compensation. Let’s

Artificial Intelligence (AI) is revolutionizing the healthcare industry, promising innovative solutions for better patient care, improved diagnostics, and streamlined operations. However, with great power comes great responsibility. Ensuring the safety and efficacy of AI in healthcare isn’t just a technical challenge; it’s a matter of life and death. At Advanced Management USA, we understand the

As we at Advanced Management USA monitor the evolving landscape of the Medicare Shared Savings Program (MSSP), we are gearing up to adapt to significant changes announced for the 2025 ACO reporting requirements. The changes, designed to streamline processes and enhance the quality of care, will undoubtedly have a broad impact on Accountable Care Organizations