Scaling Value-Based Care: Addressing Systemic Issues With Innovative Payer-Provider Collaboration

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Better relationships between payers and providers will be key to developing successful value-based initiatives that benefit patients while addressing the concerns of both stakeholders, according to panelists at the Community Oncology Alliance (COA) Payer Exchange Summit. The panel discussion highlighted the ongoing challenges and opportunities for payers and providers to collaborate on innovative, data-driven value-based…

Centering The Patient in Value-Based Care Benefits

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Forty years ago, at the height of the AIDS epidemic, HIV researchers and physicians discovered that simply treating the symptoms of the disease was not enough to provide lasting improvement for patients. Other factors like unstable living conditions, drug use, the public stigma over AIDS and HIV – known today as social determinants of health…

Strategic Cost Management Ensures ACO Viability

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For ACOs to remain relevant as leaders of Value-Based payment models, they must step up now to generate more cost savings for Medicare patient care. Budget cuts for Medicare are once again under discussion by conservatives as political pressure mounts to lower governmental spending. Meanwhile, CMS is expanding risk in Medicare value-based payment models, moving…

Hospice Executives: Value-Based Care, Regulation Will Shape Hospices’ Future

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Disruptive reimbursement and regulatory challenges are top of mind for today’s hospice c-suite executives, who recently sat down with Hospice News to discuss what they see as the largest hurdles to sustainable end-of-life care delivery. Reimbursement pressures and changes among the most significant concerns for today’s hospices, according to Kristen Yntema, president and CEO of…

One Medical Group’s Experience with AI in the Value-Based Context

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As physicians in practice become more and more burdened by administrative work, they’re finding that those burdens are impacting their sense of their effectiveness in patient care delivery. As a result, many medical group leaders are seizing the opportunity to implement artificial intelligence tools that their physicians can use. For example, AI can be leveraged…

Medicaid Accountable Care Organizations may increase care engagement and quality among pregnant and postpartum patients

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A new study has found that Medicaid ACOs in Massachusetts were associated with increases in prenatal and postpartum office visits, postpartum depression screenings, and timely postpartum care. Despite recent declines in nationwide maternal mortality, the United States continues to experience a significant maternal health crisis, in part shaped by inequitable access to quality health care…

Advancing Health Equity in Cardiovascular Care: A New Frontier

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“How can we advance health equity in cardiovascular care?” asked David Thompson, PhD, professor of nursing, School of Nursing and Midwifery, Queen’s University Belfast, Northern Ireland, on day 2 of the 2024 European Society of Cardiology Congress. To even know where to begin, it’s important to first understand that health equity and health equality are…

Value-based payment contracts come with dozens of quality measures

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Physicians working with value-based payment models are being graded on an average of 57 different quality measures a year, according to a new study. The quality measures were included in commercial and government insurance plans, with Medicare leading the number, with 15.04 quality measures per contract in 2022, according to “Value-Based Contracting in Clinical Care,”…

Value-Based Care Needs Only Five Quality Measures

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I was the editor of a healthcare business magazine for 11 years. I was in charge of hiring and firing our editorial staff of reporters, editors and designers. My performance measures for new hires were pretty simple: get to work on time, work hard, do a good job, don’t cause any trouble and leave on…