The annual government “strategy” to contain the cost of health care by cutting rates misses the cause of the problem: the fee-for-service (FFS) reimbursement model and its disconnect from outcomes that matter. By paying providers based on the number of services they deliver to each patient – tests, examinations, images, etc. – FFS incentivizes providers…
As value-based care becomes commonplace throughout the U.S. healthcare system, physicians and practices are learning how to lean into the trend. Here are seven practices and physicians leaning into value-based care in 2024: 1. Sterling Elliott, PharmD, assistant professor for orthopedic surgery and clinical pharmacist lead at Northwestern Medicine in Chicago, told Becker’s that he…
Download Slides This summer, CMS will launch its eight-year Guiding an Improved Dementia Experience (GUIDE) model where Medicare patients living with dementia and their family caregivers will be able to access comprehensive care and wraparound support services for free. This new payment model supercharges organizations like Remo Health to deliver accessible, affordable, quality dementia &…
For ACOs to remain relevant and viable under risk payment models, they must step up now to generate more cost savings for Medicare patient care. Medicare’s budget cuts are once again under consideration as political pressure mounts to lower governmental spending. CMS is expanding risk through Medicare value-based payment models, such as the new ACO…
Catalyst for Payment Reform (CPR), an independent, nonprofit coalition of employers and other healthcare purchasers, and accreditation organization URAC are working to develop an accreditation program for value-based payment programs that will be available in 2025. Most payers have implemented some form of value-based payment for healthcare providers. These models influence payment and care delivery…
Since 2021, the Centers for Medicare and Medicaid Services’ (CMS’s) Center for Medicare and Medicaid Innovation (Innovation Center) has been guided by a renewed vision to build “a health system that achieves equitable outcomes through high-quality, affordable, and person-centered care.” Health equity is one of the five strategic objectives that guide this vision. The Innovation…
Catalyst for Payment Reform (CPR), an independent, nonprofit coalition of employers and other healthcare purchasers, and accreditation organization URAC are working to develop an accreditation program for value-based payment programs that will be available in 2025. Most payers have implemented some form of value-based payment for healthcare providers. These models influence payment and care delivery…
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…
A study from the National Quality Forum (NQF) estimates that approximately 144,000 lives could be saved over 10 years by improving just two key areas of quality: colorectal cancer screening and blood pressure control. The study, published in Health Affairs Scholar, used national data to estimate the impact of improved performance on two specific quality…
A new report says that capturing participant experiences in both the Bundled Payments for Care Improvement (BPCI) Advanced Model and ACO models can help inform how bundled payments might be incorporated into ACOs in the future. In Model Year 4, the BPCI Advanced Model, which began in 2018 and is scheduled to conclude in 2025,…