Created upon enactment of the Affordable Care Act (ACA) in 2010, the Center for Medicare & Medicaid Innovation (CMS Innovation Center) was established to design, implement and test new healthcare payment and delivery models for Medicare and Medicaid. Managed by the Centers for Medicare & Medicaid Services (CMS), the CMS Innovation Center aims to achieve…
Health information exchanges (HIEs) are well-situated to help healthcare organizations achieve the triple aim of value-based care—improving population health management strategies, providing better care for individuals, and reducing healthcare costs. Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for efficiency and…
Propelled by the vision of a healthcare system that makes better, data-informed decisions, Health Data Analytics Institute (HDAI) offers a versatile analytic platform that creates a shared understanding of quantified health risks and personalized care profiles to inform actions with the greatest potential to benefit patients. The HDAI team has extensive experience working with…
Interoperability in healthcare, it would seem, is at an important inflection point. Rules around data exchange have been around for years, and regulate what patient information gets shared between payers, providers and the patients themselves. There are also standards around how that information is shared, and the forms it can take. But the transition to…
Value-based payment (VBP) models can be a useful tool for reducing health inequities and advancing equity goals. However, some evidence suggests that the uptake of VBP models has lagged in marginalized populations, and that in some circumstances VBP could exacerbate disparities. Consequently, many VBP models are now adopting a more intentional focus on equity. In…
Health care has been suffering for a while—just ask any participant, including patients. You will hear about burnout, pressures to perform, changes in the market, pressures of new technology, fiefdoms, consumerism, and to top it off, the buildup of competition between traditional health care enterprises and new corporate health care businesses. Then there’s the pandemic,…
As the United States continues to move toward value-based care, a great deal of attention has been given to vulnerable patient populations. Patients with higher needs (and correspondingly higher costs) are among those who would benefit most from healthcare improvement efforts, but those costs can represent significant risk to networks that stake their revenue on…
Given the wide expansion of value-based payment (VBP) models in the United States, VBP can be a useful tool for reducing health inequities and advancing equity goals. VBP models provide more flexibility to address social drivers of health (SDoH); they provide services and care coordination that are not typically covered but may be particularly important…
April marked the 10-year anniversary of the start of the agreement period for the first Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) – an ambitious program to reward health care providers for improving health care for people with Medicare. The program now includes 483 ACOs with over 525,000 participating…
The COVID-19 pandemic changed how healthcare organizations approach care delivery, but the industry needs more efficient and transparent data sharing methods to accelerate provider transition to value-based care models. Providers and payers alike are increasingly moving away from fee-for-service and shifting toward value-based payment models, which reimburse providers based on the quality of care they…