The year 2021 has been a dramatic one for the evolution of alternative payment models (APMs) in U.S. healthcare, from every type of accountable care organization (ACO) to bundled payments, to the rollout of the Direct Contracting program for physician groups under Medicare. That has been true both in the public and private spaces, but…
Medicaid managed care organizations (MCOs) may be better equipped to address members’ social determinants of health and health equity compared to fee-for-service models, according to a report from Health Management Associates (HMA) and Together for Better Medicaid. State Medicaid programs send requests for proposals (RFPs) to managed care organizations when preparing to enter a new…
Despite major reports in 2019 and 2021 from National Academies of Science, Engineering, and Medicine (NASEM) calling on the integration of social care into healthcare delivery, the lack of payment reform has stymied efforts by clinicians and healthcare systems to address social barriers to care and social determinants of health (SDOH), according to authors in…
Though healthcare disparities are not new, the COVID-19 pandemic brought the starkest and glaring gaps in care to the forefront. While the healthcare industry and federal and local governments have in some ways stepped up to tackle health equity, experts agree there is still a long way to go. From the need for better data…
Most healthcare payments made in 2020 were tied in some way to value or quality of care, according to the latest data from the Health Care Payment Learning & Action Network (LAN). The LAN’s latest APM Measurement report showed that 40.9 percent of US healthcare payments, representing approximately 238.8 million Americans and over 80 percent…
It has been nearly two years since the start of the pandemic, and the changes to health care delivery during this time have been significant. Providers across all specialties have had to continuously adapt the ways they offer care to ensure their patients keep receiving the services they need, when they need them. This has…
For the last several years, I have wrapped up my reporting with a look back at some of my favorite quotes from healthcare stakeholders as a way to help emphasize how our publication’s coverage is reflecting shifts in industry dynamics. In 2021, there was no question that how to build health equity into payment models,…
Analytics and reporting tools can help providers that participate in Alternative Payment Models (APMs) measure the pulse of their program performance and provide helpful insights into their population health and risk levels, as well as uncover the potential for lowering cost and improving care quality. Generally speaking, APMs are structured such that providers are measured…
Community health centers (CHCs) are respected, trusted agencies within the health care delivery sector and civic society as a whole; they are well situated to be responsive and accountable to the needs and values of their communities. Beyond health services, they can be one of multiple institutions within a community where social forces gather to…
Roughly 40% of U.S. healthcare payments were tied to alternative payment models (APMs) last year, with Medicare Advantage claims representing the largest amount, a new survey found. The survey, published Wednesday by the Health Care Payment Learning & Action Network, showed that more work needs to be done as most healthcare payments were still tied…