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Senators Whitehouse, Cassidy propose bipartisan primary care payment reform, seek industry feedback

May 15, 2024Garrett Schmitt

U.S. Sens. Sheldon Whitehouse and Bill Cassidy, M.D., want to reform how primary care providers get paid through Medicare, and they also want to hear from the healthcare industry about the best way to do it. Whitehouse, a Democrat from Rhode Island, and Cassidy, a physician and Republican from Louisiana, introduced a bipartisan bill, the…

TEAM Model: Hospitals in the Driver’s Seat, Nursing Homes as ‘Collaborators’ in Latest Bundled Payment Initiative

May 15, 2024Garrett Schmitt

The Centers for Medicare & Medicaid Services’ (CMS) in April released a bundled payment model that is the culmination of the best aspects from such past models, all to align with the agency’s efforts to get all Medicare Fee-for-Service beneficiaries involved in value-based care by 2030. The Transforming Episode Accountability Model, or TEAM, is considered…

Mental health inequities cost $477B annually, and could reach trillions

May 15, 2024Garrett Schmitt

The United States is spending nearly half a trillion dollars in avoidable expenses due to mental health inequities, and that may be just the tip of the iceberg, a new report suggests. Because of failures to provide access to the mental health needs of Americans, the country is spending an estimated $477 billion annually, according…

Building a Health Equity Focus into Value-Based Payment Design: Approaches for Medicaid Payers

May 14, 2024Garrett Schmitt

Value-based payment (VBP) models shift health care payment from rewarding volume of care provided (i.e., fee-for-service payment) to rewarding the delivery of higher value care.1 As the health care system has increased its focus on health equity, many Medicaid payers, including state agencies and managed care organizations, see promise in aligning high-priority health care payment…

RECORDED WEBINAR: Your ACO Guide to Targeting Costs with Data-Driven Strategies: Data Flush? Best ACO Options for Prioritizing Cost Initiatives

May 14, 2024Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides ACOs have struggled with lowering costs, and having the data to use smart strategies. Examine your options and possible data strategies for targeting a key area of cost avoidance: avoidable utilization and other expenses. In this webinar we’ll review the types of data that ACOs have available to them for targeting avoidable costs, and which…

LLMs in Healthcare at Scale – the promise, the reality, the cost, and the path forward

May 13, 2024Garrett Schmitt

Background As the inevitable transition to an “intelligent health system” accelerates, the development, implementation, and deployment of AI-powered solutions is moving at speeds uncharacteristic of healthcare. Leveraging intelligence in all aspects of healthcare management and operations is becoming essential in helping to address many of the industry’s most pressing challenges, including clinician burnout, increased complexity…

EHR Association Makes Recommendations on SDOH Data Capture

May 10, 2024Garrett Schmitt

A task force of the EHR Association has made recommendations for how social determinants of health (SDOH) data should be captured in electronic health records. The association’s Social Determinants of Health and Health Equity Task Force’s recently published “Recommendations for Determinant Capture,” notes that there is currently a lack of consensus around which SDOH domains…

RECORDED WEBINAR: An Inside Look: The Formula for Health Engagement and Revenue Growth

May 9, 2024Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides Join Lucerna’s healthcare engagement experts Craig Thomas, CEO, and Lynn Locke, Sr. Director of Consumer Engagement and Insights, for an inside look at how Lucerna drives increased Healthcare Engagement and Revenue Growth with an impressive 31% average conversion rate to appointments completed and over 200% lift. Whether you are a health system,…

Three things to know about CMS’s approach to behavioral health in 2024

May 8, 2024Garrett Schmitt

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) unveiled its 2024 Physician Fee Schedule final rule. It includes changes to greatly increase access to behavioral healthcare for Medicare beneficiaries. Because many compliance rules in behavioral health will be changing in 2024, and simultaneously, a new set of behavioral health professionals will…

AI-driven prior authorizations: an opportunity for advancing health equity

May 8, 2024Garrett Schmitt

Attaining health equity remains a paramount objective for health care professionals aiming to transcend the impact of socioeconomic factors on individuals’ health outcomes. The Centers for Medicare & Medicaid Services (CMS) has emphasized advancing health equity to address care disparities. Despite this effort, many communities grapple with health care access and outcomes disparities, often exacerbated…

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