As the aging population continues to shift into Medicare eligibility and toward Medicare Advantage programs, provider organizations are seeing their margins shrink to worrisome, unsustainable levels. For health systems, the time is now to pursue smart strategies for sustainability and growth. This was the main theme during an executive learning session at Becker’s 12th Annual…
The unsustainable rise of health care costs in the US, coupled with suboptimal health outcomes, is driving both conversation and real action toward value-based care (VBC) models in this country. There is no more low-hanging fruit for this effort than spine-related disorders. Low back and neck pain cost us more than $134 billion annually and continues…
Medical coding plays a vital role in healthcare, converting patient encounters into standardized codes used for billing, insurance claims, and performance tracking. Despite its behind-the-scenes nature, coding significantly impacts revenue cycles and regulatory compliance in healthcare organizations. With increased scrutiny from payers and government agencies, ensuring that medical coding practices align with current regulations has…
Since passage of the HITECH Act, which included the “Meaningful Use” financial incentive program for providers to adopt electronic health records (EHRs), acceptance of the technology has rapidly grown from 12% in 2009 to 96% in 2021, according to a federal survey. Results show that the vast majority of these EHR systems have been certified by…
What You Should Know: – Aledade, the nation’s largest network of independent primary care providers, announced the addition of over 500 new primary care practices, clinics, and community health centers to its network. – The expansion brings the total number of supported organizations to more than 2,400, serving nearly 3 million patients through value-based care programs across the…
The first installment of this series explored the financial complexities of specialty value-based care and highlighted innovative models designed to address those challenges. From bundling payments to advanced episode-based reimbursement strategies, the focus was on aligning financial incentives with high-quality outcomes while mitigating risk. Building on that foundation, this article delves into the mechanisms that…
Behavioral health has lagged behind in the shift to value-based care, and a new paper from experts at Cigna outlines why these providers should consider making the switch along with the barriers they may face. For example, there are significant technology gaps that may hinder uptake of value-based care, according to the report. Mental health…
Value-based care isn’t the only priority highlighted in The New Healthcare C-Suite Agenda: 2024-2025 Market Report. It’s just the only one where providers identified payers as part of both the solution and the problem. The new report from Sage Growth Partners is based on annual survey responses from more than 100 hospital and health system…
Analytics driven by artificial intelligence could transform value-based care by addressing long-standing inefficiencies and enabling providers to deliver better outcomes at lower costs. This is among the key findings from a HealthScape Advisors report, which also highlighted the persistent challenges facing value-based care. Despite significant investments, value-based care (VBC) has struggled to achieve its original…
University Hospitals’ accountable care organization had a math problem: More than 64,000 diabetic patients and only a few endocrinologists. Besides the lack of available endocrinologists, there is a warped perception of who should care for the estimated 129 million Americans with at least one chronic disease, according to Peter Pronovost, MD, PhD. “Across America, the…