A year ago, Sentara Health rebranded itself and launched One Sentara, an initiative to better unite its healthcare and health plan businesses to deliver a more cohesive customer experience. Technology plays a pivotal role. Sentara’s IT team has migrated most data center workloads to Microsoft Azure and is integrating disparate patient care and health plan…
In late July, the Center for Medicare and Medicaid Innovation (CMMI) announced updates to the ACO Realizing Equity, Access, and Community Health (REACH) model beginning in performance year (PY) 2025.1 This announcement coincided with the recent publication by CMMI of the Global and Professional Direct Contracting (GPDC) Model PY2022 Evaluation Report, which cites some of the early…
The transition towards value-based care (VBC) is rapidly reshaping the healthcare landscape. While this shift holds immense promise for improving patient outcomes and reducing costs, it also presents a unique set of challenges that demand careful consideration for successful contract negotiations and management. In this blog post Milliman MedInsight product manager, Umang Gupta, explains the…
Fortune 500 company DaVita is one of the largest kidney care companies in the United States. It has about $5 billion at risk in value-based contracts and is on a pathway to have about $10 billion at risk for patients with kidney disease. Jeff Giullian, M.D., chief medical officer at DaVita, recently spoke with Healthcare…
The healthcare industry’s movement away from fee-for-service care models and toward value-based care has been an incredibly gradual process. Contracting in these arrangements remains difficult for providers and payers, and clinicians continue to struggle with the administrative burden that comes along with delivering value-based care. Three healthcare experts shared their thoughts on this issue last…
According to the Primary Care Collaborative’s (PCC’s) 2024 Evidence Report, “Primary Care: The MVP of MSSP,” primary care-centric accountable care organizations (ACOs) provide better quality health outcomes and generate 2.4 times higher savings, compared to their peers. The 2024 Evidence Report, written in collaboration with Robert Graham Center and Simple Healthcare, considered more than six…
As the health care industry increasingly adopts value-based care (VBC) models, providers face the dual challenge of enhancing patient outcomes while controlling costs. To succeed in this environment, integrating health plan data — such as claims, enrollment and care gap information — into clinical and operational workflows is essential. By combining health plan data with…
We have a lifelong relationship with our health. We depend on others to help finance our health risks through insurance, doctors to advise and treat us, drug companies to create treatments, and hospitals to house and care for us when we are in our worst health. Accountability is both an individual and a shared responsibility….
The Centers for Medicare & Medicaid Services (CMS) 2025 Physician Fee Schedule (PFS) Final Rule brings notable updates to the Quality Payment Program (QPP), which will impact eligible clinicians, groups, virtual groups, subgroups, and APM entities. Whether you’re participating through MIPS, MVPs, or an ACO, these changes offer opportunities to streamline reporting, leverage new scoring…
The first regional event of Institute for Value-Based Medicine,® {IVBM), held in Boston, Massachusetts, in September 2024, brought together top minds from the top cancer centers in Massachusetts and Connecticut to examine the fine line between wanting to take value-based cancer care to the next level and considering how to bring advancements in precision medicine…