As noted in the first article in this series, traditional value-based (VBC) care models are largely focused on economic incentives to healthcare providers and facilities. Many VBC organizations lack the infrastructure in place or scale to integrate factors that impact how patients interact with the healthcare system, engage with care providers, or adhere to treatment…
Telehealth has been around for decades, but the COVID-19 pandemic thrust it into the spotlight when patients couldn’t see practitioners in-person. Suddenly, telehealth via video, audio, text, and email became a lifeline, one that’s especially beneficial for patients who have an established relationship with providers, those dealing with chronic conditions, people living in rural areas,…
Since the Affordable Care Act was signed into law in 2010, CMS has been encouraging physician practices to move from a fee-for-service payment model to one that rewards value. It has been testing models that incentivize clinicians to provide preventive, proactive, and appropriate care that improves patient outcomes and experience and decreases unnecessary healthcare spending….
Summary On January 18, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) announced Innovations in Behavioral Health (IBH), a new eight-year model focused on adult Medicaid and Medicare enrollees with moderate to severe mental health conditions and substance use disorders (SUD). CMS released substantial additional…
Download Slides Provider organizations seeking to reduce cost of care and improve quality must shift to proactive and preventative care delivery models. Mankato Clinic’s leaders will describe how they deployed Deviceless Remote Patient Monitoring to engage thousands of patients across chronic and mental health conditions and catch patients before conditions exacerbated. With better patient…
Accountable Care Organizations are struggling to find specialists to improve value-based care, although it is a top priority Centers for Medicare and Medicaid Services. Meanwhile, ACOs face considerable challenges in effectively engaging specialists, according to a recent study from the Institute for Accountable Care in the American Journal of Managed Care. The predominant influence of…
People with Traditional Medicare who undergo surgery may experience fragmented care, which can lead to complications and prolonged recoveries. To address this issue, and based on lessons learned from previous episode-based payment models, the CMS Innovation Center has proposed a new mandatory 5-year, episode-based alternative payment model that would launch in 2026. The mandatory Transforming…
Dive Brief: Accountable care organizations led by independent physicians save Medicare more money than other types of ACOs, according to a new Congressional Budget Office review of existing research. Independent physician-led ACOs have clear financial incentives to reduce hospital care to lower spending, while hospital-led ACOs — which earn more revenue when patients are admitted…
What is the transformation and what is the value-based care journey, how is the financial system in health care changing, and how does that change impact health care practice? The health care system has been steadfastly forging ahead toward a value-based care (VBC) reimbursement model over the past several years. As we enter the seventh…
Download Slides ACOs have struggled with lowering costs, and having the data to use smart strategies. Examine your options and possible data strategies for targeting a key area of cost avoidance: avoidable utilization and other expenses. In this webinar we’ll review the types of data that ACOs have available to them for targeting avoidable costs, and which…