The world of health care has changed a lot in the past decade, and the Center for Medicare and Medicaid Innovation (CMMI) at CMS has been behind a lot of that change. Radio Advisory’s Rachel Woods sat down with Liz Fowler, director of CMMI, to talk about what innovations CMMI has worked on in the…
Acquiring knowledge through advanced analytics on value-based care is a critical success factor in today’s healthcare market. Value-based care aligns diverse interests, including payers, providers, self-funded employers, third-party administrators, brokers, consultants, and patients—value-based care empowers them to deliver, manage, and drive higher patient outcomes while meaningfully managing and decreasing healthcare costs. A recent study of…
For better chronic disease management, Boston University researchers recommend replacing the term “race” with underlying factors that indicate an increased risk for heart attacks and strokes. “If other factors (instead of race itself) determine the risk differences, then the prediction equations should incorporate those factors that cause the differences in predicted risk between the races, rather than race itself….
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,…