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LTM Group Reduces Hospitalizations By 32%, Gets Clinicians ‘Engaged’ In Value-Based Care

January 18, 2024Garrett Schmitt

In today’s home health landscape, value-based purchasing is part of the race to the top. Agencies know that in order to achieve certain financial success, the outcomes have to be there. “Providers know that everybody’s getting better,” LTM Group CEO David Kerns told Home Health Care News. “That’s the whole idea of the program. If…

How Can AI Support Value-Based Care?

January 18, 2024Garrett Schmitt

Artificial Intelligence has the potential to greatly improve clinical care and support the transition to value-based care, but also comes with risks. So what role should AI play in value-based care models? The question was posed last week during a panel discussion at CES 2024 that was moderated by Dr. Jesse Ehrenfeld, president of the…

Leveraging Price Transparency Data for Provider Organizations

January 18, 2024Garrett SchmittACP, CMS, EHR

Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is “empowering consumers with the…

The Payer Federal Price Transparency Rule: Overcoming Data Challenges

January 18, 2024Garrett SchmittACP, CMS, EHR

Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is to “empowering consumers with the necessary…

Acute Hospital Care at Home data released

January 17, 2024Garrett Schmitt

The Centers for Medicare and Medicaid Services is releasing data on the Acute Hospital Care at Home initiative through the Research and Data Assistance Center. ResDAC collected data from November 27, 2020, through March 30, 2023. As required for participation, hospitals agreed to report to CMS either weekly or monthly. The Acute Hospital Care at…

Generative AI Identifies Social Determinants of Health from Doctor’s Notes

January 17, 2024Garrett Schmitt

Researchers from Mass General Brigham, reporting in npj Digital Medicine, detail their development of a generative artificial intelligence (AI) that can identify social determinants of health (SDoH) from a doctor’s notes. The new model, developed using a large language model (LLM), the finely tuned tool identified 93.8% of patients with an adverse SDoH. This compares…

Why 2024 is pivotal to embracing value-based care, data integration

January 16, 2024Garrett Schmitt

As 2024 unfolds, the healthcare industry is on the cusp of transformative changes. Propelled by technological innovations and the changing needs of patients, there’s a noticeable pivot towards care centered on the patient, focusing on outcomes. This shift heralds a significant overhaul, spotlighting models that are innovative, efficient and tailored to patient needs. Deloitte’s recent…

Health industry reignites debate over mandatory payment experiments

January 16, 2024Garrett Schmitt

The health care industry is again grappling with how aggressively to push providers into payment arrangements that hold them financially accountable for delivering better and more efficient care after the debate was largely put on hold during the pandemic. The big picture: A central question surrounding the long-running movement toward value-based care has been how…

The role of organizational design and culture in the value-based healthcare movement: The case of the Cleveland Clinic

January 16, 2024Garrett Schmitt

INTRODUCTION The Cleveland Clinic was founded in 1921 as a multi-specialty group practice staffed and run by four physicians who had served in a military hospital in France during World War I. The four men—Drs. Crile, Lower, Bunts, and Philips—were inspired by a vision of a healthcare system in which physicians “acted as a unit,”…

Optum doubles down on orthopedics, VBC

January 16, 2024Garrett Schmitt

In 2023, OptumHealth saw 900,000 more patients under value-based care, according to a Jan. 12 call with investors transcribed by Seeking Alpha.  “Value-based care for us is a proven way of overcoming many of the widely recognized shortcomings of a fee-for-service-based health system such as fragmented consumer experiences and incentives, that can emphasize volume over…

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