The annual RISE National Conference offers an opportunity for mid- to senior-level executives from managed care organizations (MCOs) to come together, share insights and perspectives, and learn about the trends and technologies shaping the healthcare industry. Here are some of the key insights we learned at RISE National 2024. OIG: MCOs Must Do Better RISE…
Data are key to understanding how value-based care has helped highlight quality benefits of hospice. The U.S. Centers for Medicare & Medicaid Services (CMS) is sunsetting the hospice component of the value-based insurance design (VBID) as of Dec. 31. Commonly called the hospice carve-in, the program in 2021 began testing the coverage of hospice through…
The momentum of value-based care is poised to accelerate. The Centers for Medicare and Medicaid Services has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030 – a notable increase from the mere 7% recorded in 2021 by Bain research. As more health plans, providers and members enter…
In the digital age, the healthcare industry is increasingly reliant on technology to streamline operations, enhance patient care, and improve outcomes. A critical aspect of this technological evolution is the interoperability of healthcare systems, particularly for medical record retrieval. Interoperability, the ability of different information systems, devices, and applications to access, exchange, integrate, and cooperatively…
Healthcare is in flux. Hospitals across the nation report clinician shortages and tight margins, and insurers are pushing more care into the lower cost settings. Forward-looking hospital leaders are feeling the pinch and getting serious about value-based care, which means promoting leaders who can embrace this value transition and innovate for the future. “I anticipate…
One way Northern Health, a major provider in Melbourne’s north, is creating value for its patients and community, is by enabling its clinicians to offer virtual options. THE PROBLEM It began during the pandemic. As with the rest of the industry, the organisation too had to accelerate its digital transformation by embracing digital tools for…
Long-term and post-acute care (LTPAC) providers play a vital role in our health system. As one of the most complex patient populations, LTPAC patients are a considerable driver of Medicare costs. According to the Medicare Payment Advisory Commission, Medicare spent nearly $57 billion on post-acute care—around 15% of total spending. Forty percent of inpatient hospital discharges…
Download Slides Join us for an insightful webinar exploring the power of collaboration between providers and health plans to achieve accurate risk-adjusted compensation. While providers and health plans may have different perspectives, there are numerous synergies and opportunities to use data analytics and drive value for patients. We’ll delve into how providers can develop…
Generative artificial intelligence (AI) is the most pivotal pragmatic change in how physicians interact with patients since the advent of the electronic health record (EHR). As health care grapples with a tremendous amount of provider burnout—and the resulting mass exit from the field—it is exciting to consider how generative AI could help restore the patient…
The Centers for Medicare & Medicaid Innovation (CMMI) has unveiled a new primary care-oriented Accountable Care Organization (ACO) payment model that holds opportunities for hospices. This demonstration reflects a push by the U.S. Centers for Medicare & Medicaid Services (CMS) to reduce fragmentation in the health care system by strengthening primary care as a hub…