The nursing home sector’s minimal participation in Accountable Care Organizations (ACOs) – largely because they have not found it lucrative to be in ACOs or have been sidelined within ACOs by other provider types – has resulted in a push for change. In a joint effort aimed at enhancing the integration of long-term and post-acute…
Fee-for-service reimbursement models have contributed to a fragmented behavioral health industry. Substance use disorder (SUD) providers are set to evolve current reimbursement models to alternative payment systems in 2024. Alternative payment models, which include risk-bearing, bundled payments and shared savings, offer a brighter future for the industry. But taking on risk and working with payers…
There has been recent policy interest in improving the affordability and access of prescription medications, including efforts to reduce disparities in access for low-income and minority beneficiaries. For example, the Inflation Reduction Act (IRA) is being implemented in response to continued concerns about drugs affordability, with a focus on reducing the price of selected drugs…
Download Slides Cost control has been hard to achieve in Value-Based Care, regardless of payment models. With lowering total cost of care (TCOC) a key Quadruple AIM goal, APP Quality Reporting opens new avenues to ACOs to amplify their opportunities to examine patient costs and create targeted interventions. In this area we’ll highlight five…
For operational efficiency, value-based initiatives need a scalable digital infrastructure that can handle multiple reimbursement models, including fee for service. Value-based care (VBC) models are designed to improve patient outcomes and reduce healthcare costs by proactively focusing on patient wellness. This preventive approach to individual and population care requires collaboration between patients, providers, payers, and…
Respondents to an American Society of Clinical Oncology survey about working with underserved populations expressed the need for a return-on-investment model to support personnel, social needs screening, and collaborating with ASCO on advocacy and policy. The ASCO Serving the Underserved Task Force was created in 2020 to address the lack of data on cancer care…
The University of Chicago Medicine Comprehensive Cancer Center has created a new center to address inequities in cancer care. The Center to Eliminate Cancer Inequity (CinEQUITY) will work to pioneer research that addresses biological, social and structural factors that adversely affect excluded or marginalized people in the Chicagoland area. The goal is to ultimately create…
Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months. But it’s unclear just how problematic that will be for accountable care organizations. The association’s allegations come from a review of two billing codes for Medicare claims data from…
The term health equity has found its way into business plans, patient-facing documents, regulations, initiatives, and the news. A recent Deloitte report noted that over 80% of c-suite executives spanning healthcare organizations and the life sciences anticipate a 2024 focus on improved health equity, flagging it as a top 10 goal for the year. In…
Recently, I’ve become uncomfortable with the buzzword of health care reform in our time: “value-based care.” We’ll look closely at that term in this article and sketch out some paths forward to something better. Some context: During the 15 years that I’ve been covering health care IT, commonplace terminology has been repeatedly re-examined. The terms…