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Hospital Execs Share Infrastructure, Quality Measure Issues in Value-Based Care

February 24, 2025Garrett Schmitt

A Feb. 24 discussion among hospital system executives at the Value-Based Payment Summit focused on the challenges and opportunities they face in transitioning to value-based care. They discussed barriers such as data management, infrastructure costs, and risk adjustment methodologies, as well as where they expect to focus their efforts in the future. Rural hospitals can…

Humana looks to deepen meaning of ‘value-based care’

February 24, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

Few buzzwords are as popular in healthcare as “value-based care.” But understanding of the term is often superficial, according to Alex Ding, MD, enterprise deputy chief medical officer at Humana. The company published its annual value-based care report in February. The annual report provides data on savings and outcomes achieved through value-based care — but…

How Climate-Driven Disasters Could Reshape Health Care Quality Measures

February 23, 2025Garrett SchmittNo Commentsrecruitment

One question is whether these results apply to other health plans beyond Medicare Advantage contracts and whether certain types of contracts may be more affected by disasters than others. For example, larger health systems may be able to triage patients to other sites of care and shift patients to facilities that are unaffected by disasters…

Value-based payment models: Doctors describe the disconnect between theory and practice

February 20, 2025Garrett Schmitt

Value-based programs have a triple aim: better care for patients, better health for populations and lower cost of health care, according to the U.S. Centers for Medicare & Medicaid Services (CMS). By 2030, CMS has a goal of 100% of Traditional Medicare beneficiaries and a vast majority of Medicaid beneficiaries participating in accountable care relationships….

RECORDED WEBINAR: Mastering Value-Based Care Networks: Insights for Competitive Edge in PY 2026

February 13, 2025Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides As value-based care organizations continue to demonstrate success and optimize their approaches, the importance of building the right value-based care (VBC) network has become increasingly important. No longer are organizations blindly creating VBC rosters. Organizations, and ultimately patients, depend on actionable insights and robust data to serve as the foundation for high-quality…

Curate Your Data to Tackle Cost of Care: Master These Basics

February 13, 2025Garrett Schmitt

The staggering reality that health care could soon account for one fifth of all domestic spending has put a bull’s eye on health care cost control. Is your ACO, health system, or physician organization ready to manage the coming congressional budget cuts? The only effective way to tackle Total Costs of Patient Care (TCoC) without…

Smart, sustainable growth in the era of Medicare Advantage — 4 takeaways

February 12, 2025Garrett SchmittCCM, Chronic Care, HCC

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…

Addressing The Burden Of Spine-Related Disorders Through Integrated Value-Based Care

February 12, 2025Garrett Schmitt

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…

Improving Audit Readiness Through Robust Medical Coding Practices

February 11, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

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…

AI and Value-Based Care Growth Igniting Fresh Urgency for Interoperability

February 11, 2025Garrett Schmitt

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…

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