The global pandemic spurred a rapid uptake of telehealth for nearly all health care providers and has permanently changed how health care is delivered. At present, providers and insurers are grappling with how to balance telehealth and in person care, focusing discussions around reimbursement models and logistical considerations. In this article, the authors discuss whether…
As team-based care becomes more common in medical practice, healthcare organizations are considering how they invest in non-clinician personnel, like recruiting and hiring community health workers. A community health worker is “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served,” according to the…
Today’s environment is one of two narratives: On one hand, there’s optimism as more Americans receive vaccines and resume in-person interactions. On the other hand, people are frustrated as the pandemic drags on with new variants and mixed guidance, and the return to normal is stymied by price inflation and supply chain disruptions. For health…
In an attempt to curb rising costs, the U.S. medical system is moving away from traditional fee-for-service healthcare. Traditional fee-for-service and volume-based healthcare models pay providers for the amount of healthcare services they provide, not the quality of that care. Value-based care is the new model: a system in which providers are paid for performance and patient…
A new partnership with Mass General Brigham and The New Commonwealth Racial Equity and Social Justice Fund (NCF) will invest $2.5 million to improve maternal health equity, support a diverse maternity practitioner workforce, and boost patient care and clinical outcomes. Particularly, the funding will help Mass General and The NCF build a cohort of Black…
Despite the growth in value-based payment arrangements from payers, health systems continue to pay physicians based on the volume of services they provide. A new study published in the journal JAMA Health Forum finds that volume-based compensation was the most common type of base pay for more than 80% of primary care physicians and for more…
Medicare’s Accountable Care Organization (ACO) Investment Model (AIM) provided up-front funding to forty-one small, rurally located ACOs to encourage their participation in the Medicare Shared Savings Program. We estimate net savings to Medicare of $381.5 million over three years, driven by utilization reductions in inpatient and other institutional care and by the absence of shared…
Accountable care organizations (ACOs) in the Medicare Shared Savings Program will care for more beneficiaries in 2022, making it the largest alternative payment model in Medicare despite lackluster ACO participation numbers this year, according to new program data from CMS. Over 11 million Medicare beneficiaries will be attributed to a provider practicing as part of…
In yet another sign that the huge debate stirred up by Donald M. Berwick, M.D., and Richard Gilfillan, M.D., by their publication on Sep. 30, 2021 of their blog in Health Affairs online, “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2: Building On The ACO Model,” is far from being quieted, yet…
In an effort to provide better healthcare at lower costs, an increasing number of payers are focusing on providing a “continuum of care.” This model strives to identify and deliver the most appropriate care for an individual based on factors such as age, lifestyle decisions, genetic predispositions, prior care received, and more. The ultimate goal…