For the first time, the Center for Medicare and Medicaid Services is proposing to establish a health equity index in the Medicare Advantage and Part D Star Ratings program that would reward excellent care for underserved populations. The proposed rule would also update the Medicare Part D medication therapy management program to require that plans include…
Value-based care has evolved into a healthcare landscape of its own, with a wide range of organizations contributing to systematic changes that improve quality of care and outcomes while better controlling costs. Providers specializing in value-based care have become attractive to investors because of the distinctive quality of care that they can provide and the…
Consumerism, autonomous operations, interoperability, healthcare access, health equity – these are some of the top issues facing healthcare CIOs and other health IT leaders in 2023, according to Pega Vice President of Healthcare Life Sciences Susan Taylor. We spoke with the health IT vendor executive to get her expert views and 2023 predictions on these…
The national movement toward value-based, accountable healthcare focusing on outcomes rather than volume of services is one of the most significant health policy developments of the last decade. Nowhere is this more critical than in primary care. In value-based delivery models, care is provided via coordinated and multidisciplinary teams focused – and paid – to…
Cognitive concerns frequently show up in primary care as adults age, although not all memory loss will progress to the dysfunction of dementia. However, the number of Americans with diagnosed Alzheimer disease (AD) could grow to nearly 14 million by 2060, up from 6.5 million currently.1 To halt that trend, much of the recent focus has…
Continuing to be a leader in the “pay-for-equity” movement, Blue Cross Blue Shield of Massachusetts announced that four of the state’s largest healthcare systems have signed agreements that link financial incentives to improvements in health equity. The four health systems are Steward Healthcare Network, Beth Israel Lahey Health, Mass General Brigham and Boston Accountable Care Organization Inc., which…
Blue Cross Blue Shield of Massachusetts has entered into value-based payment contracts focused on improving health equity with four healthcare organizations, the payer announced Thursday. The contracts are with Steward Health Care Network, Beth Israel Lahey Health, Mass General Brigham and Boston Accountable Care Organization, which is part of Boston Medical Center. In total, these…
US Senators John Barrasso (R-WY) and Sheldon Whitehouse (D-RI) have introduced a bipartisan bill that would extend value-based payment incentives for healthcare providers participating in Medicare’s alternative payment models (APMs). The Preserving Access to Value-Based Care Act will extend the 5 percent advanced APM incentive payment for an additional two years. In addition, the bill…
Key performance indicators (KPIs) have always mattered, but they are now more relevant than ever in the healthcare industry, as providers make the shift to value-based care. While there are many common types of KPI to track financial success—such as revenue or profit per employee—there are other types of KPIs that can be used to…
Social, economic, and geographic disadvantages create significant disparities in healthcare, such as lower quality of care and lesser health outcomes. To help improve these issues, the Centers for Medicare & Medicaid Services (CMS) redesigned the Global and Professional Direct Contracting Model under the new name, the Accountable Care Organization Realizing Equity, Access, and Community Health…