More than ever before, data drives the business of healthcare. The COVID-19 pandemic in particular brought statistics, data and analytics to the forefront. The healthcare industry saw real scrutiny on the sources of its data, as well as on the collection methods and analysis around it. This intensified the pressure to have accurate, streamlined and scalable data analytics capabilities…
The HIMSS Conference is history, but it generated conversations and ideas that should for some time. The HIMSS Global Health Conference & Exhibition took place in Orlando last week, bringing together thousands of people and hundreds of sessions on healthcare technology and the transformation of medicine and healthcare. Here are nine key takeaways from a…
After George Floyd’s murder in May 2020, state governments and our health care system have increased attention to racism and its impact on health equity. There has also been heightened awareness that health equity is a problem for communities other than racial and ethnic minorities, including persons with disabilities, people residing in rural communities, non-binary…
Our recent analysis of Medicare Fee-For-Service claims data continues to confirm what we have believed for years—post-acute care plays an essential role in reducing unnecessary healthcare spend in the U.S. Shifts towards value-based care and an influx of baby boomer beneficiaries promises a multitude of opportunities for home health, hospice, and skilled nursing organizations to…
Some 50 percent of hospitals in the United States are racially segregated, meaning the patient populations they serve do not reflect the demographics of their communities, according to the latest analysis from healthcare thinktank Lown Institute which was emailed to journalists. This imperils national efforts for addressing health equity. The cities with the most racially…
As we discussed in our first blog post on ACO REACH, one of the concerns about Direct Contracting was patient risk coding abuse (also called “coding intensity”). Risk coding, or risk scoring, is used by Medicare Advantage (MA) to determine the payment an MA plan will receive for a given beneficiary. Risk scoring is also…
The performance of Medicare Accountable Care Organizations has been mixed. When ACOs were first launched, the goal was to save costs and improve quality, with the Centers for Medicare and Medicaid Services offering two models with two distinct levels of risk. Now, data shows that while cost savings do, in fact, occur under both models, quality decreases….
Two years into the global COVID-19 phenomenon, it’s become very clear that patient care organizations in the United States have taken a big financial hit from the pandemic. Not only has caring for COVID-19 patients turned out to be extremely expensive, the pandemic has also scrambled hospital operations in particular, as numerous nurses, physicians, and…
On February 24th, the Centers for Medicare & Medicaid Services (CMS) revealed the highly-anticipated fate of the Innovation Center’s (CMMI) Direct Contracting model options, announcing a redesign of the Global Professional Direct Contracting (GPDC) Model and the permanent cancellation of the Geographic Direct Contracting (“Geo”) Model. The revamped and rebranded GPDC model—now called Accountable Care…
The Patient Protection and Affordable Care Act placed a greater emphasis on models of reimbursing physicians and hospitals that hold them accountable for both quality and cost of care, an approach commonly referred to as value-based purchasing (VBP). The accountable care model is a particular VBP approach that has expanded rapidly. Within a Medicare Shared…