Download Slides The Centers of Medicare and Medicaid Services (CMS) announced all patients will be in a care relationship with accountability for quality and total cost of care by 2030. Become an ACO today to practice before it becomes mandatory. CMS is offering up to $5.6 million in funds to help cover start up…
As value-based care becomes the end goal for many healthcare organizations, health systems across the country are acquiring primary care practices to achieve this mission. Critical aspects of these acquisitions include ensuring that clinician-patient relationships are uninterrupted and establishing operations that generate value for consumers, according to Matthew Weiss, MD, managing director of the EY-Parthenon…
Many referral decisions for post-acute care hinge on electronic order capability and interoperability, according to a new survey of more than 130 hospital and physician entities. Referrals are a vital part of the US healthcare system, with over a third of patients receiving specialist referrals annually. As such, obtaining a referral is a relatively common…
When it comes to value-based payment models, home health has a head start on hospice. But those providers’ experiences can lend some insights into how hospices can prepare themselves. Hospices are only now taking their first steps into value-based reimbursement. To date, much of this has centered around diversified programs like palliative care, PACE and…
Market strategies to drive transformation of healthcare delivery and payment towards value are at a cross-roads. In response, health plan VBC strategy success will depend on their ability to develop and deploy specialty VBC models. Industry advancements in value-based care (VBC) have resulted in a meaningful restructuring of health plan and provider organizations, processes and…
Value-based care participation is lacking among primary care physicians; most practices reported receiving fee-for-service payments in 2022, according to data from the Commonwealth Fund. Full Article
Download Slides Accountable care organizations (ACOs) leverage data and population insights to mitigate risk and improve patient health outcomes, and this starts with access to preventive care. Gap closure programs for preventive care include services such as screenings, annual visits, vaccinations, and more. However, only 8% of U.S. adults receive recommended preventive care. First…
The different social determinants of health have different impacts on healthcare quality, utilization, and outcomes, with new Humana data showing that some SDOH are more closely related to poor care quality while others are more closely related to high healthcare utilization. For other SDOH, like social isolation and limited access to transportation, patients experience both…
On March 31, 2023, Centers for Medicare and Medicaid Services (CMS) released the annual 2024 Medicare Advantage and Part D Rate Announcement (Rate Notice), which is the final guidance on rates for Medicare Advantage in 2024. As we explained in our prior blog posts (here and here), one of the more substantial changes proposed for…
Health disparities aren’t just a result of the inequities in the healthcare system, but also other socioeconomic areas including housing, nutrition and education. To tackle these challenges, the healthcare industry is going to need to work with other sectors, declared Hans Kluge, regional director for Europe at the World Health Organization. “One of the big…