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 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….
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…
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…
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…