Efforts to make the healthcare system more efficient and equitable by adjusting population-based payments for social risk factors may be missing the mark, suggests a new study from Harvard and Yale. The study published in the latest edition of Health Affairsputs current risk adjustment methodologies under a microscope to find out if they truly support…
As the industry moves deeper into value-based payment models and takes accountability for the health of populations, primary care is serving as one of the highest priorities for health systems and networks alike. We are at a critical juncture where independent, affiliated and employed physicians, as well as the employers and health systems working with…
CareJourney is a leading source of provider cost and quality analytics for the healthcare industry. They support payers, value-based networks and numerous ACOs, helping them assess value-based care models, optimize provider performance, coordinate patient care and uncover market growth opportunities. CareJourney does this by consolidating and enriching Medicare FFS, Medicare Advantage and Medicare and Commercial claims…
Medical Home Network (MHN) isn’t new to care coordination. For 14 years, the Chicago-based accountable care organization (ACO) has focused on bringing care coordination into the primary care office, using community health workers to provide whole-person care. But now, as a part of the ACO REACH Model, MHN looks forward to a future free from the…
As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We asked the Healthcare IT Today community to submit their predictions and we received a wide ranging set of responses that we grouped into a number of themes. Check out our communities predictions below…
After finding that only six of its 50 alternative payment models (APMs) “generated statistically significant savings to Medicare and to taxpayers,” CMS and the Center for Medicare and Medicaid Innovation (CMMI) hope that 2023 will refresh its value-based care (VBC) efforts. Here are four updates to its newest VBC model — ACO REACH — as…
Social determinants of health impact people’s well-being and quality of life. These social determinants—conditions such as access to nutrition, safe and affordable housing, jobs, transportation, and access to health care—are some of the factors that lead to disparities in health and health care if they are not addressed. “Defining and assessing social determinants of health…
Health equity affects all of us—either directly or indirectly—and the lack of equity could be pushing us into a financial crisis. Health equity is the fair and just opportunity for every individual to achieve their full potential in all aspects of health and well-being. Health inequities cost us $320 billion a year. If we don’t…
Though providing hospital-level care at home is not a new concept, the popularity of such programs grew during the COVID-19 pandemic. As cases of the deadly coronavirus began surging in March 2020, healthcare organizations nationwide halted various types of in-person care due to capacity constraints and fears of exposing people to the virus. As they…
The U.S. health system has been evolving over the past decade to focus on the quality and value of care. Until recently, though, value-based payment models have not explicitly addressed longstanding racial and ethnic inequities in care. This month, Blue Cross Blue Shield of Massachusetts, the not-for-profit health plan I lead, introduced a value-based payment…