The shift toward value-based care (VBC) is increasingly taking hold in health care as practices continue to face challenges with stagnant fee-for-servicereimbursement rates and medical cost inflation. To succeed in a VBC environment, practices must adopt patient engagement as a foundational capability. Better patient engagement not only helps keep patients healthy and from needing higher-cost…
Effective population health management requires collecting, processing, and analyzing large amounts of patient data, making data analytics tools key for any population health initiative. Population health is often conceptualized based on a definition in a review published in the March 2003 issue of the American Journal of Public Health, which states that the term refers to…
A transition to value-based reimbursement would fundamentally change the traditional hospice business model. It could also wield a powerful influence on an organization’s culture. Hospices are inching ever closer to the value-based arena. To date, much of this has centered around diversified programs like palliative care, PACE and other services. However, the ongoing value-based insurance…
An ONC analysis shows that 83 percent of non-federal acute care hospitals participate in some social determinants of health (SDOH) data collection. Still, challenges related to routine screening data collection exist. SDOH specifically refers to the environments in which individuals live, work, and play. When these social needs, such as transportation, housing, and food security,…
While value-based care adoption has accelerated in the healthcare industry, the alternative care delivery and payment model is still lacking in the pediatric setting. The current healthcare infrastructure does not support the resources needed to successfully implement this model for kids, according to Rachel Thornton, MD, vice president and chief health equity officer at Nemours…
Medicaid expansion is close in North Carolina, with the Republican-led legislature passing and the Democratic Governor Roy Cooper signing the Access to Health Care Options legislation to take effect with passage of the state budget for the 2024 fiscal year. A distinctive feature of this result is the strong bipartisan legislative vote. Other states have…
Seventeen of the nation’s leading stakeholders in healthcare are backing a bipartisan House bill recently introduced to Congress that would reinforce Medicare’s move to value-based care. The support of the Value in Health Care Act of 2023, a bipartisan legislation that would make several important reforms to ensure alternative payment models (APMs) continue to produce…
In an effort to improve care quality and lower costs, the healthcare industry has been working on shifting from fee-for-service to value-based care delivery. The two models differ in the way providers are reimbursed for the care they provide by rewarding them service-by-service or based on overall quality and patient outcomes. In the following article, HealthPayerIntelligence breaks…
Integrating episodes of care within your population health infrastructure can drive higher value specialty care and increase savings earned. While CMS aims to support more coordination between bundles and ACOs, organizations should set a specialty care strategy that works for them. Specialty care accounts for a disproportionate share of healthcare expenditures in the US, driven in part…
When the nonprofit behind the most popular performance measurement tool implemented health equity measures, it begged the question: how can healthcare organizations measure equity? Healthcare industry leaders recognize the importance of the overarching issue. Almost 90 percent of healthcare executives agreed that health equity should be one of the industry’s priorities. “We know what we can’t see and what…