On Tuesday, Nov. 1, the federal Centers for Medicare & Medicaid Services (CMS) issued its calendar year 2023 Physician Fee Schedule (PFS) final rule, and with it, the agency made meaningful changes to the parameters of the Medicare Shared Savings Program (MSSP), with health equity the principle around which the major changes announced were made….
Social determinants of health (SDoH)—the conditions in which people live and the systems that shape those conditions—are increasingly receiving attention. The COVID-19 pandemic, by exacerbating inequities and highlighting the prevalence of unmet basic needs,1 has accelerated efforts to address SDoH.2 State Medicaid agencies, payers, providers, vendors, community-based organizations (CBOs), and other stakeholders have taken up the…
Download Slides Providers, in the face of turbulent financial times, require proactive leadership to evolve their organization’s business model. TriHealth, a large community health system in Cincinnati, has already embarked on the journey to transitioning a significant amount of revenue from fee-for-service to fee-for-value. Leadership at TriHealth has invested in a host of value-based…
As the health care industry increasingly shifts to value-based care (VBC) and alternative payment models, its biggest challenge is inertia. Fee-for-service (FFS) and pay-for-performance (P4P) have been firmly entrenched for years, along with the associated business processes and costly legacy systems that support them. To fully realize VBC’s value, these existing processes and legacy infrastructures…
Interoperability of sex/gender EHR elements could help support research to improve population health, according to a study published in JAMIA. Researchers examined recommendations from the National Academies of Sciences, Engineering, and Medicine (NASEM) report “Measuring Sex, Gender Identity, and Sexual Orientation” and the Health Level 7 (HL7) Gender Harmony Project (GHP) product brief “Gender Harmony—Modeling…
Value-based care in its simplest definition rests on the assurance of value for every healthcare dollar spent. The term “value” though, is open to interpretation. Which means that it is subject to each beholder’s working definition of what “value” means, and therefore the resultant expectation of a standard around it. Over the last decade, value-based…
Buying health insurance is a lot like renting an apartment. Finding the perfect place is hard, and the price is always higher than you expect. But if it is conveniently close to your employer and there are few other affordable options, you sign the lease and agree to all of the terms. Only after a…
Earlier this month, a few members of the Healthjump Healthcare Organization team, Dane Rasmuson and Calli Styczynski attended the Florida Association of ACOs (FLAACOs) 2022 Annual Conference. This article explores some of the valuable insights they gained from the nation’s leading experts in value-based care. “FLAACOs was the perfect combination of a well-established yet personal…
The electronic health record (EHR) is an essential tool for linking demographic and clinical data within and across health care systems, as well as to public health databases. Data collected within the EHR are crucial for understanding and addressing inequities that negatively impact health and health care outcomes of marginalized communities, including persons with disabilities….
Today, behavioral health providers want to deliver effective treatment that brings hope and healing to patients. They also want to be reimbursed well and quickly so they can invest in the best resources and personnel. Value-based care can help providers achieve both. It orients practices and payers toward the most important factor in mental health…