The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus the…
Loneliness and social isolation rose alarmingly during the COVID-19 pandemic as lockdowns proliferated and in-person gatherings were discouraged. A critical social determinant of health (SDOH), social isolation is estimated to have increased by 6.7 percentage points during the pandemic. To help combat this and other SDOH issues, providers and payers are turning to data analytics. Several companies have…
The Center for Medicare and Medicaid Innovations (CMMI) recently announced the ACO Realizing Equity, Access, and Community Health (REACH) Model. The REACH Model will replace the Direct Contracting model starting on 1/1/23. ACO REACH retains the DC Model Global and Professional tracks and adds new requirements to advance equity, promote provider governance, and protect beneficiaries….
François de Brantes is senior vice president of Episodes of Care at Signify Health and has been designing and implementing value-based payment programs for over a decade. For Signify Health, he leads customer development of Medicare Advantage, self-insured employer, and commercial payer markets. In this interview, Mr de Brantes discusses alternative payment models, advancing value-based…
Covid-19 played a pivotal role in accelerating years of digital health adoption, with the proliferation of telehealth at the forefront. According to a McKinsey report, telehealth utilization for office visits and outpatient care increased by 78 times between February and April 2020, as patients, providers and payers sought to navigate the safe delivery of healthcare…
As the healthcare industry focuses on value-based care, tracking data on health outcomes among patient populations will be crucial. Both population health and public health focus on improving care and outcomes across large groups of patients. While they may sound similar, population and public health have important distinctions. What Is the Population Health Approach to…
The Pharmacy Quality Alliance (PQA) has a new pharmacy performance measure that evaluates adherence to medications for diabetes, renin angiotensin system antagonists for hypertension, and statins for high cholesterol through a single composite measure.1 Although many might think the PQA already had member-endorsed adherence measures for these medications, the situation is a bit nuanced. There…
Attend any healthcare conference and you’ll quickly discover that it’s become downright fashionable for healthcare leaders to talk about their unwavering commitment to “value-based care.” The expression has become ubiquitous in healthcare circles. Its virtuousness goes unchallenged. But should that be the case? Michael E. Porter and Elizabeth Teisberg (with whom I worked as a…
For health care providers and payers, changes to the Stark Law, the Anti-Kickback Statute, and the reimbursement landscape encourage providing care that addresses social determinants of health for certain patient populations. Research shows that when medical care is delivered alongside non-medical services that affect health, patients, providers, and the health care system overall are better…
The Pharmacy Quality Alliance (PQA) has a new pharmacy performance measure that evaluates adherence to medications for diabetes, renin angiotensin system antagonists for hypertension, and statins for high cholesterol through a single composite measure. Although many might think the PQA already had member-endorsed adherence measures for these medications, the situation is a bit nuanced. There…