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The Medicare Shared Savings Program (MSSP) is one of the most significant reforms in U.S. healthcare payment policy, shifting the system away from traditional fee-for-service reimbursement toward value-based care. Created in 2010 under the Affordable Care Act with an establishment deadline of January 1, 2012, the MSSP encourages healthcare providers to coordinate care, improve quality, […]

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

The U.S. Department of Justice recently announced one of the largest coordinated healthcare fraud enforcement actions in history—charging 324 individuals across the country in schemes involving over $2.75 billion in alleged false billings. The charges span telemedicine, pharmaceuticals, home health, and durable medical equipment fraud, affecting some of the most vulnerable patient populations. You can

As the healthcare landscape shifts toward value-based care, Advanced Management USA is proud to lead the charge. We are now accepting new practices into our nationally recognized Accountable Care Organizations (ACOs) for the 2026 Medicare Shared Savings Program (MSSP) performance year. The final deadline to join is August 1, 2025, and the opportunity to align

The U.S. healthcare system is undergoing a transformative shift from fee-for-service to value-based care (VBC), with Accountable Care Organizations (ACOs) at the forefront. For primary care providers (PCPs), medical offices, and healthcare administrators, this transition presents a timely opportunity to enhance patient outcomes, streamline operations, and unlock new revenue streams. CMS’s 2030 Vision: A Call

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