As we move through the second half of 2024, managed care organizations must prioritize member engagement, especially for individuals with chronic conditions. This period presents an opportunity to embrace strategies that encourage essential healthcare visits, such as annual wellness and primary care appointments. Read on for member engagement tactics that focus on precise member identification,…
Abstract Issue: During the past 14 years, the federal government and states have fielded numerous value-based payment (VBP) models for primary care to move away from a fee-for-service payment model that incentivizes the delivery of more services over better-quality care. However, most primary care practitioners (PCPs) do not participate in VBP models, and the reasons…
Download Slides More than six months into the CMS-HCC V28 rollout, it’s clearer now than ever before that we need true national interoperability. In this webinar, Credo Founder and CEO Carm Huntress will provide an overview of TEFCA and the current state of interoperability. He’ll also explain how AI can help solve some of…
July brings us baseball, fireworks, and CMS’s Proposed Rules. In 2,248 pages of proposals, CMS has outlined its plans for MIPS, ACOs, and other Advanced Alternate Payment Models, and how they will transition from fee-for-service into a value-based care arrangement through the Quality Payment Program (QPP). We already know from the 2024 Final Rule that…
Download Slides To remain competitive, ACOs, Medical Groups, and Physician Networks must control costs, while simultaneously delivering excellent care. Creating a long-term transformation strategy that harmonizes primary and speciality services into whole-person care that fulfills these objectives can be a daunting task, particularly at the beginning of your value-based care journey. However, there’s no need to…
Download Slides Value-based care (VBC) arrangements between payers and providers continue to grow, fueled by the Center for Medicare and Medicaid’s (CMS’) ambitious goal of achieving 100% accountable care for Medicare beneficiaries by 2030. To be successful under these arrangements, provider organizations need to understand the VBC landscape and the levers they have available…
It’s 2024, and we’re living in a digital world. Yet far too many healthcare providers are making do with outdated and incomplete methods for collecting, analyzing, and using medical records. With the rollout of CMS-HCC V28, the publication of TEFCA 2.0, and the continued push for national interoperability, now is the time for value-based care…
Value-based specialty care can help transform care delivery and improve patient experiences and outcomes, so it’s no surprise that it has been major topic of conversation this year. A common refrain heard at healthcare conferences and in industry media is that value-based specialty care is coming, and healthcare organizations can either get on board or…
Within the health care system, payers and physicians have long operated at odds with one another. While both have a goal to improve patient and member health, their approaches often differ, creating friction. Physicians get frustrated when they have limited information about how data are collected and used to calculate patient attribution and payments. They…
Pediatrics has been at the forefront of preventive medical practices such as immunizations, screenings, care coordination with specialists and meeting defined health goals. Measurable prevention is a major cornerstone of providing value-based care, so it would seem the approach would pair well with pediatrics. But it’s not that simple, because there is a wide range…