Emergency departments (EDs) are under more pressure than ever. Apart from the growing patient volumes, staffing shortages, and increasing expectations to deliver safe, high-quality care, EDs are also a frequent destination for some of the most vulnerable patients, those transferred from skilled nursing facilities (SNFs) and other post-acute facilities. Too often, SNF patients arrive with…

ABSTRACT Value-based payment (VBP) models are increasingly adopted in oncology to promote high-quality, cost-effective, and patient-centered care. To identify essential characteristics of effective oncology VBP models, a modified Delphi process was conducted with 9 experts representing diverse oncology organizations. Panelists participated in 2 survey rounds and an in-person discussion, evaluating the importance and feasibility of key…

Good data is the lifeblood of good healthcare. Ensuring the right information is available to the right care team members at the right time is essential to delivering high-quality care. Two recent trends in healthcare are underscoring this fact. The first, unavoidably, is artificial intelligence. It is critical to have clean and well-governed to make…

The ACCESS Model is designed to expand tech-enabled care for Medicare beneficiaries with certain chronic conditions, aligning payments with outcomes for better patient health. What’s the impact? A Medicare model targeting conditions like hypertension, diabetes, chronic pain, and depression with scalable, tech-supported solutions. Providers, tech firms, and health systems gain new reimbursement pathways; applications open…

For over a decade, stakeholders across the healthcare industry have told a story of transformation. The healthcare industry has daydreamed about value-based care. We’ve nodded along (and sometimes nodded off) at conferences as visions of transformation were illustrated with elaborate slide decks, and applauded pilot programs that promise to finally—finally—align payment with patient outcomes. And…

The Medicare Shared Savings Program (MSSP) is the largest federal initiative that promotes accountable care and value-based payment models. A central design feature of the program is its tiered approach to financial risk. ACOs generally begin in one-sided models and share in a portion of the savings generated but are insulated from losses if costs…