Value-Based Care payment models are based on a clear CMS goal: lower Total Cost of Care and its counterpart, Total Per Capita Cost. But neither TCoC nor TPCC gives you the information you need to target your cost efforts. How to start? Begin by evaluating what initiatives you need to do in the five key…
Gartner estimates “over 95% of new digital workloads will be deployed on cloud-native platforms” by 2025. This shift from on-premise solutions to a cloud-based, software-as-a-service (SaaS) model, where software is accessed via a web browser, may seem concerning to healthcare organizations for several reasons, with the primary reason being a perceived loss of control. Organizations…
DataLink provides flexible data-driven solutions that help value-based care providers, payers, and organizations improve quality performance, optimize risk accuracy, and reduce costs. With intelligent insights, automated workflows, and advanced interoperability technology, DataLink simplifies value-based care so that providers can focus on what matters most: delivering the best health outcomes. Data-Link is widely recognized for…
Health care costs in the United States are rising every year, leading to poorer patient outcomes, high out-of-pocket payments, and a consolidated market. One factor driving this rise is how siloed our health care system is. Not only are patients being forced to pay high out-of-pocket costs, but independent physicians are also feeling the pressure,…
Value-based care (VBC) is not new. The concept began in the 1980s with the introduction of managed care and capitation models, where providers were paid a set amount per patient rather than per service. However, it gained significant traction in the early 2000s and continues to evolve with ongoing efforts to refine payment models, improve…
Achieving the Centers for Medicare and Medicaid Services’ (CMS’s) goal to bring every Medicare patient into a value-based care (VBC) arrangement by 2030 requires bold action. With six years left to achieve that goal (as of January 2024), only half of current Medicare beneficiaries are aligned with an accountable care organization (ACO) providing care within…
As the post-acute care industry continues transitioning towards a value-based care system, skilled nursing facilities (SNFs) should start to consider participating in an Accountable Care Organization (ACO) to not only help in achieving optimal outcomes but improving patient care journeys uniformly. Building a clinically robust continuum of care includes long-term acute and post-acute care hospitals…
The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed a new avenue of funding for Accountable Care Organizations (ACOs) with implications for palliative care providers. The agency’s 2025 Physician Fee Schedule proposed rule contains a provision that would establish a new “prepaid shared savings” option for Medicare Shared Savings Program (MSSP) participants. This…
The Centers for Medicare & Medicaid Services (CMS) quietly released changes to the ACO REACH Model, prompting one industry group to react to the modifications. The National Association of ACOs (NAACOS) said it is still digesting the changes and listening to members’ initial thoughts. “I think it’s a bit mixed,” Aisha Pittman, senior vice president…
The Department of Health and Human Services (HHS) regularly refines its policies and operational guidelines in an ongoing effort to better serve patients and support sustainable value-based care delivery. To that end, HHS and CMS recently announced three important updates: Revisions to HHS risk adjustment model algorithm software Changes to cost-sharing reductions (CSRs) Deployment of…