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83% of Acute Care Hospitals Engage in Some SDOH Data Collection

August 2, 2023Garrett Schmitt

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,…

Investments Are Needed to Implement Value-Based Care in Pediatrics

August 2, 2023Garrett Schmitt

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…

North Carolina’s Bipartisan Path To Medicaid Expansion: The Role Of Accountable Care

July 31, 2023Garrett Schmitt

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…

Value in Health Care Act of 2023 Introduced to Congress to Reinforce Value-Based Care

July 29, 2023Garrett Schmitt

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…

Value-Based Care and Fee-For-Service: What’s the Difference?

July 25, 2023Garrett SchmittACA, AMA, FFS, HEDIS, MA, Medicare Advantage, NCQA

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…

How Integrated Bundles Drive High Value Specialty Care

July 24, 2023Garrett SchmittAttribution, referral management, specialty care

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…

How Healthcare Orgs Can Improve Their Health Equity Measures

July 24, 2023Garrett Schmitthealth equity, NCQA

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…

Retail Giants Vs. Health Systems: Fight Will Come Down To ‘Systemness’

July 24, 2023Garrett SchmittEHR, ICD-10-CM

Value-based healthcare, the holy grail of American medicine, has three parts: excellent clinical quality, convenient access and affordability for all. And as with the holy grail of medieval legend, the quest for value-based care has been filled with failure. In the 20th century, U.S. medical groups and hospital systems could—at best—achieve two elements of value-based…

Common Utilization Measures That Impact Value-Based Care Efforts

July 20, 2023Garrett SchmittHEDIS, NCQA, Triple Aim, Utilization Management

Quality and quantity have a nuanced relationship in the healthcare system: put simply, payers want to reduce members’ quantity of low-value services while increasing the number of services that produce better quality care. As a result, utilization measures that track the use of high- and low-value care are critical to a value-based structure. The triple aims of value-based…

RECORDED WEBINAR: Leveraging digital health to improve quality metrics that matter

July 20, 2023Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides Healthcare organizations that participate in value-based care arrangements are at the forefront of transforming healthcare delivery by improving quality, patient experiences, and cost management. To excel in this pivotal role, organizations must navigate the intricate landscape of quality measure achievement. In this enlightening webinar, we will explore how digital health can revolutionize…

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