The Impact of the Quality Payment Program (QPP) on Provider Reimbursement

The QPP includes fundamental charges to how Medicare Part B compensates providers beginning in 2019. The QPP creates a predictable payment system for providers that is aligned with improving quality and cost and eases the transition to value-based care.

Valuable Insights Alert: 2020 Quality Payment Program Proposed Rule Released

Kathleen Gravelle, CareAllies Chief Risk Officer, and former program examiner at The White House Office of Management and Budget, provides an update on what was announced.

(6 min)

Group-Based Trajectory Models to Identify Sociodemographic and Clinical Predictors of Adherence Patterns to Statin Therapy Among Older Adults

Published by American Health & Drug Benefits in June/July 2019 edition. Research by Aisha Vadhariya, PhD Candidate; Marc L. Fleming, PhD, MPH, RPh; Michael L. Johnson, PhD; E. James Essien, MD, DrPH; Omar Serna, PharmD, BCACP, Clinical Operations Director at CareAllies; Tara Esse, PharmD, BCACP, Clinical Program Manager at CareAllies; Jeannie Choi, PharmD; Susan H. Boklage, MS, MPH; Susan M. Abughosh, PhD.

Medication Adherence to Antihypertensive Triple-Combination Therapy Among Patients Enrolled in a Medicare Advantage Plan

Published by the Journal of Managed Care & Specialty Pharmacy in June 2019. Research by Xin Wang, PhD; Hua Chen, MD, PhD; Ekere Essien, MD, PhD; Jun Wu, PhD; Omar Serna, PharmD, BCACP; Rutugandha Paranjpe, MS; Susan Abughosh, PhD.

Valuable Insights: Diabetes Education

In this Valuable Insights podcast, we spoke with Audrey Jones, MD at Advantage Health Clinic in Alamo, Texas and Olga Oviedo, RN, MSN, certified diabetes educator at CareAllies, to understand how they identify and support patients who need additional diabetes education.

(14 min)

Your Participation for Medicare Shared Savings Program in 2019

This digital tool can help you determine which track you can participate in. Tracks correspond to your accountable care organization's (ACO's) proportion of revenue to expenditures and previous experience with risk.

Awareness Of The Atherosclerotic Cardiovascular Disease Risk Estimator Among Primary Care Physicians In A Medicare Advantage Plan

Published by Journal of Behavioral Health in April 2019. Research by Scarlet Najera; Tara Esse, PharmD, BCACP; Omar Serna, PharmD, BCACP; Aisha Vadhariya; Sanika Rege; Marc Fleming; Susan Abughosh; Jeannie Choi.

Valuable Insights: How Does Your Shared Savings Program Quality Reporting Affect Your MIPS Score?

Erin DeLoreto, assistant vice president of value-based programs for CareAllies, explains how your Shared Savings Program quality reporting impacts your MIPS score.

(.5 CME credit)

Valuable Insights: Getting Care and Appointments Quickly

Meredith Herpel, Cigna-HealthSpring Stars customer satisfaction, discusses how wait times can affect patient experience and satisfaction.

(.5 CME credit)

Valuable Insights: The Quality Payment Program

Kathleen Gravelle, chief risk officer for CareAllies, provides an overview of the Medicare incentive program.

(.5 CME credit)

Provider Intervention Increases Medication Adherence

Mayank Shah, MD, chief medical officer of Home-based Care Delivery Services, discussed how pharmacy professionals worked with providers to identify opportunities that improve health outcomes and affordability for their patients.

Valuable Insights Alert: Medicare Shared Savings Program Final Rule Released

On December 21st, the Centers for Medicare and Medicaid Services issued a final rule to update the Medicare Shared Savings Program, which includes retiring the traditional participation "tracks" and replacing them with new tracks for both existing and new accountable care organizations (ACOs). Kathleen Gravelle, CareAllies chief risk officer, and former program examiner at The White House Office of Management and Budget, provides an update on what was announced.

(5 min)

Giving You Insights That You Really Value

Beckie Croes, senior vice president of provider engagement and management services at CareAllies, discussed the highlights of our 2018 Valuable Insights education series and the enhancements made throughout the year based on provider feedback.

Effectiveness Of Mailed Letters To Improve Medication Adherence Among Medicare Advantage Plan Participants With Chronic Conditions

Published and licensed by Dove Medical Press Limited in December 2018. Research by Amanda Mann, PharmD; Tara Esse, PharmD, BCACP; Omar Serna, PharmD, BCACP; Liana Castel, PhD; Susan Abughosh, PhD.

Valuable Insights: Patient Engagement

Dr. Nicholas Gettas, CareAllies contributor, discusses best practices for getting and keeping patients engaged in their health.

(.5 CME credit)

Valuable Insights: Preventive Screenings

Dr. Diana Lozano from Valley Medicine Associates in Harlingen, Texas and Gina Dominguez, RN, embedded care coordinator for CareAllies discussed how they engage with patients to help get them the preventive care they need.

(13 min)

Valuable Insights Alert: 2019 Quality Payment Program Final Rule

On November 1st, the Centers for Medicare and Medicaid Services issued a final rule to update the 2019 Quality Payment Program, which was created under the Medicare Access and CHIP Reauthorization Act (MACRA). Kathleen Gravelle, CareAllies chief risk officer, and former program examiner at The White House Office of Management and Budget, provides an update on what was announced.

(5 min)

Valuable Insights: High-five for Physician Engagement

Beckie Croes, senior vice president of provider engagement for CareAllies, discussed best practices for motivating physicians and the support you need to succeed.

.5 CME credit

Valuable Insights: Medicare Advantage and Part D Star Ratings

Evet Rodrigues, CareAllies contributor and expert on Stars, CAHPS & HOS, discussed how to win by improving your patient experience.

CME credits: 1.0

Valuable Insights: Medication Adherence

William Torkildsen, MD from Port Isabel Health Clinic, and Rickie Cruz, LVN, an embedded care coordinator for CareAllies, discuss how they implemented a medication adherence tracker that helped make patients 20 times more likely to fill their prescriptions. (15 min)

Predict, Prioritize and Prevent

Rick Bennett, director of informatics and analytics, and Nicole Deaner, MSW, director of practice transformation for CareAllies discussed how to proactively drive cost rather than cost driving you (crazy).

Valuable Insights: Accountable Care

Dr. Nicholas Gettas, CareAllies contributor, discussed maximizing your clinical relationships for “value-able” care.

CME credits: 0.75

Valuable Insights Alert: Medicare Shared Savings Program Proposed Rule Released

On August 9, 2018, the Centers for Medicare and Medicaid Services issued a proposed rule to update the Medicare Shared Savings Program. Erin DeLoreto, assistant vice president of value-based programs for CareAllies, gives a 7-minute update on what was announced and the potential changes to the program.

Valuable Insights: Converting Data to Actionable Information

Rick Bennett, director of informatics and analytics at CareAllies, and Nicole Deaner, MSW, director of practice transformation at CareAllies discussed how to proactively drive cost rather than cost driving you (crazy).

Crucial Access: Primary Care

John Parente, MD, chief medical informatics officer of CareAllies, shares insights on developing PCP access strategies.

Valuable Insights: Care Delivered

John Parente, MD, chief medical informatics officer at CareAllies, discussed innovative access strategies to improve care delivery.

Taking Control of Your Outpatient Costs

Olan Soremekun, MD, MBA, vice president of value-based programs at CareAllies, on what physicians need to know to be in control of their outpatient costs and quality health outcomes.

Driving Your Financial Performance

Beckie Croes, senior vice president of provider engagement for CareAllies, led a discussion on the top drivers of financial performance for independent physicians.

Valuable Insights: Who’s Driving The Bus?

Beckie Croes, Senior Vice President, Provider Engagement at CareAllies, discusses top drivers of your financial performance and how to ensure you’re taking the wheel.

A Motivational Interviewing Intervention by Pharmacy Students to Improve Medication Adherence

Published in the May 2017 Journal of Managed Care & Specialty Pharmacy. Research by Susan Abughosh, PhD; Xin Wang, MS; Omar Serna, PharmD, BCACP; Tara Esse, PharmD, BCACP; Amanda Mann, PharmD; Santhi Masilamani, PharmD, CDE, MBA; Marcia McDonnell Holstad, PhD, FNP-BC; Ekere James Essien, MD, DrPH; and Marc Fleming, PhD, MPH.

Transform Your Organization with Physician Engagement

This white paper will help you to:

• Understand the effect provider engagement can have on your organization’s clinical and business performance
• Evaluate the engagement of providers in your organization
• Review tools and strategies to improve provider motivation

CareAllies Can Help You Successfully Transition to Value-based Care

We have the expertise and experience needed to develop solutions based on your needs now and as you grow.

Physician Perception of Patient Medication Adherence in a Cohort of Medicare Advantage Plans in Texas

Published in the March 2016 Journal of Managed Care & Specialty Pharmacy. Research by Amanda Winters, PharmD; Tara Esse, PharmD, BCACP; Archita Bhansali, MS; Omar Serna, PharmD, BCACP; Shivani Mhatre, PhD; Sujit Sansgiry, PhD.

Evaluating Pharmacist-Written Recommendations to Providers in a Medicare Advantage Plan: Factors Associated with Provider Acceptance

Published in the January 2016 Journal of Managed Care & Specialty Pharmacy. Research by Amanda Mann, PharmD; Tara Esse, PharmD, BCACP; Susan M. Abughosh, PhD; Omar Serna, PharmD, BCACP.

A Pharmacist Telephone Intervention to Identify Adherence Barriers and Improve Adherence Among Nonadherent Patients with Comorbid Hypertension and Diabetes in a Medicare Advantage Plan

Published in the January 2016 Journal of Managed Care & Specialty Pharmacy. Research by Susan M. Abughosh, PhD; Xin Wang, MS; Omar Serna, PharmD, BCACP; Chris Henges, PharmD; Santhi Masilamani, PharmD, CDE, MBA; Ekere James Essien, MD, DrPH; Nancy Chung, PharmD, BCACP; and Marc Fleming, PhD.

Quality Compensation Programs: Are They Worth All the Hype? A Comparison of Outcomes Within a Medicare Advantage Heart Failure Population

Published in the May 2013 Journal of Managed Care Pharmacy. Research by Tara Esse, PharmD, BCACP; Omar Serna, PharmD, BCACP; Abhishek Chitnis, PhD; Michael Johnson, PhD; and Nelson Fernandez, MD.