The Centers for Medicare and Medicaid Services is looking to improve its data in ways that contribute to a fairer healthcare system, including continuing the development of equity scores and refining the Health Equity Summary Score, as well as addressing bias in various tools and methods. The CMS Framework for Health Equity outlines this approach,…
Affordable Care Act (ACA) marketplace officials are hoping to get more plans into value-based care arrangements as regulators hope to not just build on getting people covered, according to federal officials. Officials with the Centers for Medicare & Medicaid Services (CMS) spoke Thursday at the Health Care Payment Learning and Action Network Summit on value-based…
Download Slides When it comes to participating in risk-based payment models, value-based care organizations can no longer fly blind- that is, operate without trusted, robust, detailed analytics. Data and analytics are ubiquitous, and necessary in order to know the effectiveness and value of the care you are providing or contracting. In this webinar, we’ll…
The introduction of the phrase “value-based care” into the industry lexicon can be tracked back to 2010 driven by the reforms of the Affordable Care Act (ACA). The HMOs of the 1990s weren’t balanced with quality, access, consumerism, nor were they tech enabled. They indeed failed spectacularly but moving back to FFS indefinitely wasn’t the…
Healthcare is undergoing a transformation and value-based care is taking center stage. American physicians are increasingly participating, with 54% of them reporting being in at least one accountable care organization. This figure jumped 10% from 2018 to 2020, according to the American Medical Association during their Physician Practice Benchmark Survey. Although participation is increasing, common…
Innovation in healthcare is accelerating. Seismic changes include adoption of virtual health modalities spurred by the COVID-19 pandemic, disruption in the payer sector by tech-based upstarts, and the expansion of care settings outside the hospital. In this environment, in October 2021 the Center for Medicare & Medicaid Innovation (CMMI) published its innovation strategy for the…
With the health care industry continuing to evolve toward a value-based care model, data interoperability has become more crucial. In this interview with Integrated Healthcare Executive, Mark Braunstein, MD, professor of the practice emeritus at Georgia Tech and board of directors’ member at Rimdi, Inc, describes how substitutable medical applications and reusable technologies (SMART) on…
As our country continues to reflect on the devastating impact of Covid-19 and the World Health Organization noted that the ‘end is in sight’ for the pandemic, we need to recognize and address the disproportionate hardships that Black and Latino communities have faced over the last two plus years. Latino communities, who experienced some of…
Just over half of Medicaid managed-care plans have health equity strategies for specific populations of members, and around 4 in 10 have health equity plans for all of their members, a survey from the Institute for Medicaid Innovation found. The institute’s fifth annual “Medicaid Health Plan Survey” includes data from almost every state with managed…
It’s here. The 2023 CMS Physician Fee Schedule Final Rule has been released, and in a mere 3,304 pages, CMS has largely finalized its proposals from over the summer. To save you from pouring through all the minutiae, here’s what you need to know. Overall, in this Final Rule, CMS has codified principles to fulfill…