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…
Providers and payers play key roles in healthcare delivery. More often than not, the two must collaborate to ensure that patients and beneficiaries move through their care journeys as efficiently as possible while complying with state and federal regulations. Despite this shared goal, the relationship between providers and payers can be strained by information exchange…
Federally Qualified Health Centers (FQHCs) are a breed apart. Incorporating multispecialty practices with primary care, behavioral health, and even dental care, these 1,400 providers across the US see some 30 million Americans a year, many insured by Medicare and Medicaid. One such FQHC, Cherry Health, covering western Michigan and headquartered in Grand Rapids, serves more…
On Dec. 12, Elizabeth Fowler, Ph.D., J.D., the director of the Center for Medicare and Medicaid Innovation (CMMI), engaged in a lively Q&A with the Penn Medicine community in Philadelphia moderated by Rachel Werner, M.D., PhD., the executive director of Penn’s Leonard Davis Institute of Health Economics. Fowler began by talking about several projects currently…