Resources for your organization.
Physician alignment and clinical integration can affect your organization's clinical and financial performance. No matter where you are on your journey to value-based care, CareAllies is here to help.
Why Star Ratings Are Important for Providers, Too
As AEP ramps up, Medicare Advantage plans are a unique offering for consumers. For value-based care providers, working in partnership with a highly rated plan can make a huge difference in the health of both their patients and their practice. Medicare’s Star Ratings do not paint the entire picture of a health plan’s quality. However, they do help patients select plans more attuned to their care and service needs.READ MORE
Valuable Insights: How Pharmacists Elevate Team-based Care
Esteban Gallardo, PharmD., Chief of Pharmacy for CareAllies, discusses how physician organizations can elevate team-based care by incorporating clinical pharmacists. He also offers insight into how pharmacists help optimize medication use, improve patient care, reduce total cost of care, and impact patient and provider satisfaction.
(10 min)LISTEN HERE
Using Value-Based Models to Help Improve Health Equity
To best address the obstacles preventing us from reaching health equity for all - providers, payers, communities, governments, and corporations must work together to implement creative solutions that solve the root problem. In this Expert Perspective, Susan Harriger, RN, MSW, LSW, CCM, Clincal Program Manager for CareAllies, discusses how value-based care models serve a critical role in offering health care providers greater flexibility to tackle health equity challenges.READ MORE
Helping Older Patients Get Comfortable Talking About Mental Health
One in five people over the age of 55 have at least one mental health concern, with depression and anxiety being the most common. Dr. Alfred Wettermark, Northeast Regional Medical Executive for CareAllies, discusses the many factors that can negatively impact an older person's mental health.
Direct Contracting: Finding Meaning in the Acronyms
GPDC, DCE, and ACO REACH. These acronyms are all associated with evolving demonstration models being assessed by the Center for Medicare & Medicaid Innovation (the CMS Innovation Center). They can seem like jumbled letters in an alphabet soup of Medicare programs.
Corey Redding, Executive Director for CareAllies Accountable Care Solutions, LLC, takes a look at what these acronyms stand for and, more importantly, what they mean for providers now and in the future.
Documenting Chronic Conditions: Getting It Done Consistently
Health care providers and health plans have long known about the importance of comprehensive patient care documentation. Dr. Joe Nicholson, Chief Medical Officer for CareAllies, explains how providers and payers can get a complete picture of the patient’s health and the interventions being used to manage it when care is fully documented.
Valuable Insights: Improving Patient Care for Original Medicare Beneficiaries
Corey Redding, Executive Director of CareAllies Accountable Care Solutions, discusses the role of CMS Innovation Center’s test models in shaping the future of value-based care. He also offers brief insight into the redesign of the Global and Professional Direct Contracting Model to ACO REACH Model and how it impacts patient care, especially for original Medicare beneficiaries.
Physician Engagement In Value-Based Care Strategy Remains A Challenge
With the cost of care rising every year for health care services, a reimbursement method that incentivizes high quality care at lower costs is imperative, yet the industry still has been slow to adopt them. To better understand the challenges and needs of providers as they make or plan their transition, CareAllies partnered with Modern Healthcare Custom Media to survey 138 health care professionals about this topic.
How to Talk with Patients About Health Care Power of Attorney Decisions
Approaching the subject of power of attorney is a difficult reality that health care professionals must have from time to time. Dr. Armando Hinojosa from Valley Organized Physicians, an IPA managed by CareAllies, shares how to have challenging conversations that help set patients up for the best possible outcome, both for themselves and their support system.
New Payment Models Can Help Solve Persistent Health Equity Challenges
Sadly, people who face economic, geographic, and socially determined disadvantages can struggle to access quality health care and often fail to reach their full health potential. Corey Redding, Executive Director for CareAllies Accountable Care Solutions, LLC, shares how health inequities can directly impact a person’s long-term well-being, their likelihood of getting or surviving serious diseases, and their access to treatment to quickly respond to escalating health conditions.
Valuable Insights: Evidence-Based Prescribing in Systolic Heart Failure
In this webcast, Vicente Aparicio, Clinical Pharmacist for CareAllies, discusses the use of guideline-recommended medication to reduce the risk of hospitalizations or death due to systolic heart failure. Watch as he takes a deep dive into essential HFrEF therapies, guideline recommended drug therapy in systolic heart failure and medication adherence.
(0.5 CME credits)
Interview with KevinMD: How to Close Gaps in Social Determinants of Health
In this interview, Dr. Joe Nicholson, CareAllies Chief Medical Officer, shares his story and discusses his KevinMD article, "It is time to make a dent in social determinants of health."
(1.0 CME credits)
Completing Annual Physicals, the First Quarter: A Best Practice that Can Pay Off
Dr. Alfred Wettermark, Regional Medical Executive of the Northeast for CareAllies, discusses how medical practices that can get their patients in for annual physicals during the first quarter of the year can see benefits in terms of better patient care, improved quality metrics, and stronger performance in value-based agreements (VBAs).
Accountable Care is Here to Stay
To celebrate more than 10 years of work transitioning the U.S. health system to value-based care, the CMS Innovation Center is embarking on a strategic initiative to refresh its approach and drive more equitable health outcomes for Medicare and Medicaid beneficiaries. Corey Redding, Executive Director for CareAllies Accountable Care Solutions, LLC, offers thoughts on what this initiative means for providers.
What’s Ahead in 2022
Is it time to start rethinking traditional care delivery models, so they become nimbler and more attuned to patients’ needs—the clinical ones, as well as the socioeconomic and environmental ones? As organizations contemplate which path to take, Dr. Joe Nicholson, chief medical officer for CareAllies, predicts the three key areas where we are going to see some changes this year.
AHIP Webinar Replay: Removing Obstacles and Building Bridges to Stronger Relationships
In this webinar, Dr. Joseph Nicholson, CareAllies Chief Medical Officer, and Josh Cook, Cigna Medicare Market President for Texas/Oklahoma, discussed how they work closely with provider networks to remove obstacles and change traditional health care relationships, improving outcomes and financial health for all.
Valuable Insights Alert: 2022 PFS Quality Payment Program Final Rule Released
On 11/2/2021, the Centers for Medicare and Medicaid Services issued a final rule on the 2022 Physician Fee Schedule, which includes updates to the Quality Payment Program (QPP). Jameira Johnson, Value-Based Programs Administrator for CareAllies, provides an update on the announcement.
Overcoming Vaccine Hesitancy: The Key is in the Conversation
In this article, Dr. Elizabeth Stahl, Regional Medical Director for CareAllies, discusses the essential role health care providers play in helping patients understand the reasons behind proactive health care and why these services are so critical. Given that flu season is here, and this year, families and loved ones will be anxious to gather for the holidays, there hs never been a better time to reach out to patients and talk through how to stay safe and healthy.
Demystifying Direct Contracting
Direct contracting is a term that has been floating around a lot across our industry recently. Joe Nicholson, DO, CareAllies chief medical officer, provides a quick look at what it is, what makes it different from more familiar risk-sharing structures, and why it is important.
Valuable Insights: Navigating Through COVID-19 Vaccine Hesitation
In this webcast, Dr. Elizabeth Stahl, Regional Medical Director for CareAllies, discusses how to successfully navigate through vaccine hesitation and how to drive conversations to help educate patients on their vaccine options. Watch as she takes a deep dive into current COVID-19 trends and statistics, understanding patient hesitation and maneuvering conversations to resolve hesitations.
(0.5 CME credits)
Seizing the Moment: Learning from the Pandemic to Rethink Care
In this article, Rob Cetti, CareAllies president, discusses how now is the time to learn from the experiences of 2020 and put clinical and financial structures in place to better navigate, weather, and even thrive during unexpected and volatile times.
5 Advantages of Practice Aggregation
Sustaining an independent practice might seem like a pipe dream to some physicians these days—but it is not. Joe Nicholson, DO, CareAllies chief medical officer, discusses how aggregating with other like-minded practices enables providers to stay independent while at the same time reaping key financial and patient experience benefits.
Evaluating Perceptions of Social determinants of Health and Part D Star Performance of Medicare Advantage-Contracted Primary Care Providers Serving a South Texas Market
Published in the Journal of Managed Care & Specialty Pharmacy May 2021 edition. Research by Ryan Payne, PharmD, at CareAllies; Tara Esse, PharmD, BCACP, at CareAllies; Jessica Qian, BA at CareAllies; Anjana Mohan, PhD Candidate; Aisha Vadhariya, PhD; Gina Becho-Dominguez, BSN, RN; Omar Serna, PharmD, BCACP at CareAllies; Kim Villarreal, LCSW, CCM at CareAllies; Susan Abughosh, PhD
AMGA Replay: How Provider Engagement Partners Evolve a Practice
It can be daunting for organizations to consider taking on new payment models, but with industry partner support, practices’ quality performance and financial results can be significant. Dr. William Torkildsen, Chairman of Valley Organized Physicians, and Dr. Joe Nicholson, Chief Medical Officer for CareAllies, shared their experiences during this AMGA Annual Conference session, “Vendor vs. Partner - How Provider Engagement Partners Evolve a Practice”.
Keep The Wheels Rolling: When—And How—To Move Up The Value-Based Road
Kristen Daigle, Value-Based Contracting Lead for CareAllies, discusses why a collaborative partnership is critical to move an organization forward along the APM model. CareAllies works with provider organizations - at any stage - to move them along the APM model.
Valuable Insights: May Regulatory Review
In this 3-minute video, Kathleen Gravelle, CareAllies contributor, provides an update on health care-related actions made by the federal government. In May’s video, she discusses the 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) proposed rule and Merit-based Incentive Payment System (MIPS) program exceptions.
NAACOS Spring Conference Session Replay: APM Performance Pathway
Finalized in December 2020, the APM Performance Pathway (APP) will dramatically shift the way in which ACOs report quality data to CMS. On the surface, the APP will lessen the need for manual chart review. Digging deeper, however, reporting via the APP will require ACOs and their participating physicians to report quality on all their patient populations: not just original Medicare beneficiaries attributed to the ACO. In this NAACOS Spring 2021 Conference session Erin DeLoreto, VP of Value-based Programs for CareAllies, provided an overview on what these changes mean for ACOs.
International Women’s Day 2021: Celebrating One of Our Favorite Women in Leadership
As we observe International Women’s Day 2021, celebrating women in leadership, we asked one of our CareAllies leaders – Dr. Ramapriya Suresh – to share some of her experience and perspective with us.
Communication Strategies to Build Patient Confidence
Dr. Joe Nicholson, chief medical officer for CareAllies, provides recommendations about how providers can handle efficient COVID-19 vaccine rollout and patient communications to build confidence and trust, and reiterate the importance of preventive care to unique patient populations.
How Supporting Risk Based Agreements Can Advance Value-based Care
In this webinar, hosted by the ACO Exhibit Hall, CareAllies Chief Medical Officer, Dr. Joseph Nicholson and IKP Family Medicine President, Dr. Timothy Irvine, discuss how value-based payment isn’t just about risk. It’s also about gaining flexibility and financial stability.
What Practices Should Learn from Netflix
Joe Nicholson, DO, chief medical officer for CareAllies, discusses how practices that take a flexible, innovative approach to improving patients’ access to care can more easily attract and retain patients—and thereby solidify practice success. He also discusses how better patient access enhances both patient and provider satisfaction—all of which factor into increased practice viability.
Patient-reported Barriers To Statin Adherence: Excerpts From A Motivational Interviewing Intervention In Older Adults
Published in the Journal of the American Pharmacists Association January - February 2021 edition. Research by Aisha Vadhariya, PhD; Rutugandha Paranjpe, MS, PhD; Ekere J. Essien, MD, DrPH; Michael L. Johnson, PhD; Marc L. Fleming, PhD, MPH, BSPharm; Tara W. Esse, PharmD, BCACP at CareAllies; Esteban Gallardo, PharmD at CareAllies; Omar Serna, PharmD, BCACP at CareAllies; Jeannie Choi, PharmD; Susan Boklage, MS, MPH; and Susan M. Abughosh, PhD.
Breaking Down Barriers: Environmental Conditions and Housing Instability
The neighborhoods and housing people live in have a major impact on their health and well-being. In this series, we suggest ways you can help break down these barriers.
Valuable Insights: Preventive Vaccinations
Encouraging patients to get their preventive vaccinations is important for a number of reasons. In this webcast Meredith Herpel, Cigna Stars Customer Satisfaction, talks about barriers to patient engagement and how to overcome them.
(.5 CME credit)
Valuable Insights: Drive-thru Clinic
The current environment is motivating providers to experiment with new ways to ease patients’ concerns while continuing to provide quality care. In this podcast, we talked to Dr. Armando Hinojosa in Laredo, Texas about the drive-thru clinic option his practice is offering patients.
5 Steps To Create A Value-Based Care Organization
Peter Gardner, vice president of provider engagement operations at CareAllies, and Allen Perez, senior vice president of business development at CareAllies, discuss how moving to value-based care models is critical for the success of a practice, but doing so needs to be carefully planned. There are five steps that practices can take to start moving down the path to those models.
Valuable Insights: Rethinking Clinic Design
A number of changes aimed at minimizing the spread of infection have been recommended in face-to-face settings. In addition to promoting these best practices, Dr. Joe Nicholson, Chief Medical Officer for CareAllies, discusses clinic design changes that can be made to enhance the safety of your patients, care team and staff.
Alternative Payment Models: Practices’ Best Bet to Weather Future Financial Storms
Casey McKeon, CareAllies contributor, discusses how alternative payment models can offer practices steadier revenue streams and greater stability alongside strategies to drive higher care quality, and which APM models should practices consider.
Continuum of Risk-Based Models
The Alternative Payment Model (APM) Framework provides a comprehensive view of the four approaches to payments - each moving health care organizations progressively towards population-based models.
Valuable Insights: Addressing the Social and Environmental Needs of Patients During COVID-19
Research has shown that non-clinical care, including a person's social and environmental conditions, can impact up to 80% of their health care outcomes. In this podcast, Kim Villarreal discusses how her team has been connecting with patients during COVID-19 to help answer questions, calm their fears and make sure they have what they need.
Breaking Down Barriers: Social Determinants of Health
There’s more to patients’ overall well-being than their physical health. But, there’s also more to addressing their overall well-being than the choices they make and the clinical care they receive. In this series, we suggest ways you can help break down these barriers.
Breaking Down Barriers: Language and Health Literacy
Low health literacy, as well as language barriers, may impact a person’s ability to take responsibility for their health, as well as the health of their family. In this series, we suggest ways you can help break down these barriers.
Breaking Down Barriers: Violence and Abuse
Violence affects patients of all ages, and it doesn’t just impact them physically. It can also have long-term emotional effects. In this series, we suggest ways you can help break down these barriers.
Valuable Insights: Preparing for Disasters and Emergencies
We have all been impacted by COVID-19, but we need to acknowledge the possibility of additional disasters and emergencies. Dr. Joe Nicholson, CareAllies Chief Medical Officer, and Dr. Priya Suresh, Renaissance Physicians Chief Medical Officer, discuss preparing your practice, patients and employees for disasters and emergencies.
Breaking Down Barriers: Food Insecurity and Access to Foods That Support Healthful Eating
Fresh and nutritious foods are essential to good health. But for many, eating a healthful diet is not as simple as choosing to do so. In this series, we suggest ways you can help break down these barriers.
Breaking Down Barriers: Social Isolation
Social isolation can have a significant impact on patients’ overall well-being, especially elderly patients. In this series, we suggest ways you can help break down these barriers.
Social Determinants of Health COVID-19 Outreach Protocol
During these difficult times, it is important to reach out to patients who may need additional support addressing social determinants of health. The CareAllies Community Health Advocate Team (CHAT) created this guide to help you outline outreach protocols for your organization.
Evaluating Success Factors of a Medication Adherence Tracker Pilot Program in Improving Part D Medication Adherence Metrics in a Medicare Advantage Plan: Importance of Provider Engagement
Published by Journal of Managed Care & Specialty Pharmacy May 2020 edition. Research by Minh Hong, PharmD at CareAllies; Tara Esse, PharmD, BCACP at CareAllies; Aisha Vadhariya, PhD; Esteban Gallardo, PharmD at CareAllies; Maream Ashley Fosshat, PharmD at CareAllies; Jocelyne Mamvou, PharmD at CareAllies; Liana Bruce, PhD, MSPH; Omar Serna, PharmD, BCACP at CareAllies, and Susan Abughosh, PhD
Dr. Torkildsen Discusses The Medication Adherence Tracker Case Study During the 2019 APG Colloquium
Dr. William Torkildsen, Valley Organized Physicians Chairman, participated in the APG Colloquium panel, Case Studies in Excellence 2019: Pearls of Wisdom from the Field. Watch his portion of the panel to hear him talk about working with their management company, CareAllies, to improve medication adherence.
Valuable Insights: Annual Wellness Visits
Erin DeLoreto, assistant vice president, and Sandy Santangelo, quality manager, value-based programs, discuss identifying Medicare fee-for-service beneficiary health and risk factors through Annual Wellness Visits.
(.5 CME credit)
Valuable Insights: Care Coordination
Meredith Herpel from the Cigna Medicare Stars customer satisfaction team, talks about the impact care coordination can have on the patient experience.
(.5 CME credit)
Improving Outcomes and Patient Experience Through Medication Adherence
Medication adherence plays a vital role in ensuring that patients achieve desired health outcomes. But despite its importance in keeping patients well, adherence remains a challenge. To address medication adherence in South Texas, Valley Organized Physicians worked with CareAllies to develop a Medication Adherence Tracker (MAT). Dr. William Torkildsen will present this case study on the MAT during the APG Colloquium's Case Studies in Excellence 2019: Pearls of Wisdom from the Field.
Enhancing Statin Adherence Using a Motivational Interviewing Intervention and Past Adherence Trajectories in Patients with Suboptimal Adherence
Published by the Journal of Managed Care & Speciality Pharmacy in October 2019 edition. Research by Susan M. Abughosh, PhD; Aisha Vadhariya, PhD; Michael L. Johnson, PhD; E. James Essien, MD, DrPH; Tara Esse, PharmD, BCACP, Clinical Program Manager at CareAllies; Omar Serna, PharmD, BCACP, Clinical Operations Director at CareAllies; Esteban Gallardo, PharmD, Clinical Program Manager at CareAllies; Susan H. Boklage, MS, MPH; Jeannie Choi, PharmD; Marcia M. Holstad, PhD, FNP-BC, FAAN; and Marc L. Fleming, PhD, MPH, RPh
Valuable Insights: Reducing Readmissions
In this podcast we spoke with Teresa Alonzo, RN, BSN, an Alegis Care Transition of Care nurse, about the in-home care interventions she conducts with patients after they have been discharged from the hospital.
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.
Your Track Options for Participation in the Medicare Shared Savings Program
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.
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, CareAllies contributor, provides an overview of the Medicare incentive program.
(.5 CME credit)
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.
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.
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.