Congratulations! Your organization has been approved to join a value-based care payment model. Your provider contracts are signed, your attribution estimates are finalized, and you are preparing a primary care coordination strategy. Now, what comes next as you prepare for your upcoming performance year? It’s time to build out your preferred specialist network. Fulfilling Network…
In less than a decade, social determinants of health (SDOH) have evolved from a new concept into a core strategic imperative for healthcare providers, payers and government health agencies alike. Few question the importance of addressing the nonclinical factors that impact health on an individual and population level. However, organizations often face obstacles in gathering…
One in five people over the age of 55 have at least one mental health concern, with depression and anxiety being the most common. There are many factors that can negatively impact an older person’s mental health. Declining physical health, the onset of multiple chronic conditions, less independence, and more limited social interactions can lead…
The COVID-19 pandemic has shown the tight link between data and equity. Data are critical to identifying disparities, promoting social mobility, and advancing health for our communities. But gaps in data can have the opposite effect. Without data, opportunities to address inequities and social justice are erased. Although more than 27 percent of US adults…
Most value-based payment programs have failed to significantly reduce healthcare spending or improve the quality of care for patients. Many have actually resulted in higher healthcare spending, and some have made it harder for patients with complex conditions to receive adequate care. The reason current programs have failed is that payers have tried to create…
Two physician healthcare policy leaders are offering an examination of the value-based delivery and payment movement in healthcare from a health equity perspective, and have concluded that, while healthcare reimbursement reform can provide one element in moving the needle on health equity, it alone cannot provide a vehicle that will transform the U.S. healthcare system…
The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits to significantly impact the shift to value-based care. The CY 2023 PFS proposed rule included changes to the Medicare Shared…
The COVID-19 pandemic supercharged in-home care in the U.S. Suddenly it became possible to get a house call from a primary care provider; home-based physical therapy, dialysis, or an infusion of medicine; even a full complement of hospital-level services at home became possible. And Americans overwhelmingly liked it. The Centers for Medicare & Medicaid Services…
Download Slides ACO REACH participants face a number of new challenges starting January 1, 2023. CMS will require every participating ACO to have a health equity plan in place to successfully identify, engage, and intervene with socially vulnerable populations. Organizations will be measured and evaluated based on their ability to execute this health equity…
The CMS outlined potential guidance last week on issues like healthcare equity and climate change in its final inpatient payment rule as the federal government heightens its healthcare oversight on social issues. In the report, the CMS released comments that it received after soliciting public input during its proposed rule in April. The feedback on…