Health and well-being require far more than medical care. Research shows that personal behaviors, physical environments and socioeconomic factors—commonly referred to as social drivers of health (SDOH)—are responsible for 80 percent of health outcomes. Individuals enrolled in Medicaid experience disproportionate rates of complex health and social needs. With this in mind, state Medicaid agencies are…
Global health equity won’t be achieved until everyone—no matter who they are, where they live or what their means are—can access the best possible healthcare providers and treatments. Most people in regulated industries like data aggregation or healthcare are familiar with the EU’s General Data Protection Regulation (GDPR) of 2018, which is designed to protect…
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…