The value-based care payment and care delivery model has been evolving for more than a decade, and with the right risk tolerance and aligned incentives, it promises to benefit patients, providers and payers. “While the adoption has been windy, there are clear signs of VBC’s stickiness and growing footprint,” explained John Fryer, chief revenue officer…
The United States is one of the most dangerous among wealthy nations for women to give birth. Disturbingly, it’s even more dangerous for women of color. Black women are about three times more likely to die from pregnancy-related complications than white women, while maternal mortality rates among American Indian and Alaska Native (AIAN) women are two times higher. The COVID-19 pandemic…
Accountable Care Organizations (ACOs) know they need to follow regulations. That means adhering to Centers for Medicare & Medicaid Services (CMS) requirements for REACH ACOs to develop and maintain comprehensive health equity plans. For 2023, REACH ACOs are not being penalized for their health equity plan if it does not work in practice and only…
The American Hospital Association wants it to be easier for hospitals nationwide to begin adopting episode-based payment models, such as bundled payments, the trade association wrote in a recent letter to the Centers for Medicare and Medicaid Services (CMS). The letter addressed to CMS Administrator Chiquita Brooks-LaSure comes in response to a CMS request for…
On Aug. 24, officials at the federal Centers for Medicare & Medicaid Services (CMS) announced the results of 2022 monetary savings coming out of the Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs). Federal healthcare officials praised the MSSP program for its having saved Medicare $1.8 billion in 2022. Among the highlight results:…
While the HITECH Act of 2009 spurred widespread EHR adoption across healthcare organizations, national health information exchange (HIE) investments have largely left out community-based referral organizations, limiting social determinants of health (SDOH) data interoperability. SDOH data exchange is key for improving population health, with factors such as housing, food and nutrition, transportation, and education accounting…
Health system executive teams are in a bind as expenses rise faster than reimbursement rates, and margins are expected to stay slim for the next few years. With few options to mitigate costs and avoid cutting services, layoffs or worse, hospitals and health systems are accelerating value-based care strategies and taking a more nuanced approach…
“We have providers all the time saying, ‘I want a value-based contract.’ But when you ask them why, they have no idea.” — Chasity Howell, Vice President of Provider Relations for Indiana Medicaid MCO MDWise “Value-based care really is a shift in the paradigm. Providers deliver care on an individual patient level. Now, we’re asking…
Most Americans support the idea of value-based care but don’t understand or resonate with the term, according to new research from United States of Care. USofCare is a self-described nonpartisan think tank focused on building a more equitable healthcare system. Its latest research relied on (PDF) virtual focus groups with a dozen participants, a national…
Value-based care models incentivize healthcare providers to improve care delivery by tying reimbursement to care quality. While value-based care holds providers more accountable for patient health outcomes, it also affords them the resources and time needed to improve care quality. As of 2021, nearly 60 percent of healthcare payments stemmed from value-based models, according to…