The Holy Grail in healthcare today is a patient-centered, value-based care system. However, achieving this is not easy and some healthcare organizations are better suited than others to achieve this difficult transition away from fee-for-service, according to the Business Group on Health. The organization, which is a nonprofit that advocates for employers, believes that payers may be…
Arizona’s Medicaid agency, the Arizona Healthcare Cost Containment System (AHCCCS), has launched several health information exchange (HIE) initiatives in recent years in efforts to improve health equity for the American Indian population. Health disparities among American Indian/Alaska Native (AI/AN) people are vast, ranging from greater difficulties affording healthcare to poor maternity care access and high…
Download Slides The COVID 19 pandemic exposed numerous vulnerabilities and weaknesses in our society as whole and especially within our healthcare systems. In this moderated discussion, we will address the factors that contributed to the breakdown of our complex healthcare systems as well as lessons learned from this crisis. Finally, we will provide recommendations for…
Hospices and Accountable Care Organizations have the ability to customize payment contracts within the Realizing Equity, Access and Community Health (ACO REACH) program. Effective Jan. 1, 2023, the U.S. Centers for Medicare & Medicaid Services (CMS) is replacing the Global and Professional Direct Contracting (GPDC) model with ACO REACH. The agency says the new program…
Health in the United States is not equally distributed; there is a 15-year gap in life expectancybetween the richest and poorest 1 percent of Americans. There is clear evidence that health and health inequities are largely determined by the conditions in which we are born, grow, live, work, and age—the social determinants of health (SDOH)….
Download Slides If you are just starting your approach to Value-Based Care and considering an ACO or other type of APM, where in the world should you start? While some of the early adopters began by rounding up their usual physicians and filing an ACO application, it’s no longer that easy. Value-based care payments now…
Privia Quality Network is one of the top earners of the Medicare Shared Savings Program, the federal government’s largest running accountable care organization (ACO) program. Across its four ACOs, Privia saved the program $380 million in 2021 while earning a weighted average quality score level of 93 percent. The key to their success? Physician engagement…
Many academic medical centers (AMCs) struggle to find success with risk-based contracts. The FFS operating model, combined with financial challenges and lack of strategic alignment across various stakeholders, can hold AMCs back from fully committing to the change required to fully embrace value-based care. The required shift in culture and finance can seem overwhelming, but…
For all the challenges facing the leaders of patient care organizations in moving forward in their value-based contracting in a time in healthcare strongly affected by the COVID-19 pandemic and policy and payment changes, some integrated health systems are doing well and showing excellent results, including in the Medicare Shared Savings Program (MSSP) sponsored by…
The COVID-19 pandemic has exposed for many the reality that vast inequities exist in the nation’s health care system. That can be particularly true for children and families, many of whom face barriers to access and unequal care outcomes as a result of many factors and social determinants of health. Finding a solution to make…