The transition from fee-for-service medicine to value-based payments represents the greatest shift in healthcare in more than a century; according to CMS, by 2030 the vast majority of this country’s estimated $6.8 trillion healthcare spending will be tied directly to patient outcomes and satisfaction. This shift represents a material win for patients – but what…
Download Slides Technology is one of the most important tools for providing high-quality care but can also create the most significant barriers for patients and providers. Without this bridge, organizations are compromising security, provider satisfaction, patient care, missing opportunities to connect with referring providers, enhance in-network optimization, and streamline access to providers and resources….
Ask a healthcare organization what its top priority is today, and many will say health equity. But when it comes to creating real change, paying lip service won’t cut it, one executive said. “It’s virtue signaling,” said SCAN Health Plan CEO Sachin Jain in a recent interview. “It’s fashionable to say you care about this….
One focus of the HL7 Da Vinci Project FHIR accelerator has been member attribution lists used by payers and providers for implementing value-based contracts, care gap closures and quality reporting. MultiCare Connected Care (MCC), an accountable care organization in Washington State, recently deployed a FHIR-based application programming interface (API) to help solve the attribution issue….
In 2021, the Centers for Medicare & Medicaid Services (CMS) established a goal to have 100 percent of Original Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care relationships by 2030 as part of the Center for Medicare and Medicaid Innovation’s (Innovation Center) strategic refresh. This means that beneficiaries should experience longitudinal,…
Since the emergence of the COVID-19 pandemic, many healthcare leaders and experts have said the pandemic has vividly illustrated the inequities in health treatment and outcomes among disadvantaged groups. Eboné Carrington, managing director of Manatt Health, said those disparities in healthcare among minority groups and those with lower incomes haven’t exactly been hidden. The fact…
A strong business case exists for addressing the financial impacts of social determinants of health (SDoH) and new reimbursement models designed to emphasize health equity. Involving revenue cycle management (RCM) is necessary for any comprehensive SDoH/health equity strategy. This is because health disparities contribute more than $93 billion in unnecessary medical care costs and more than $42 billion annually…
Amid an uncertain economy, providers, payers, and patients alike will be turning their attention to value-based care models to cut costs and improve health outcomes. These models, where reimbursement is rewarded based on quality of care, have taken center stage once again in the healthcare discussion. During the pandemic, the industry saw a rapid move…
Jails can provide opportunities to diagnose and treat individuals for HIV. However, supporting care coordination for formerly incarcerated individuals upon reentry into the community can be difficult due to data sharing challenges. Current CDC guidelines for HIV care post-release recommend providing individuals with a 30-day supply of their HIV medication and an appointment with a…
Traditionally, healthcare in the U.S. has been based on a fee-for-service reimbursement model, where providers are paid for each service delivered to patients. The problem with this model is that pay is tied to volume, not outcomes— in fact, providers are incentivized to perform extra testing and procedures, emphasizing treatment at the expense of prevention…