As they gain experience with alternative payment models, how can healthcare executives do a better job of partnering with community-based organizations (CBOs) to address patients’ health-related social needs and decide what is meaningful to measure? A panel of innovators at the Health Care Payer Learning & Action Network (LAN) Summit in Washington, D.C., described their…
Providers face monetary disincentives for violating information blocking, under a proposed rule released today by the Department of Health and Human Services. The proposed rule, with 60-day comment period, would establish disincentives for healthcare providers found by the HHS Office of Inspector General (OIG) to have committed information blocking. This is when a provider knowingly and…
Value-based care is often discussed in the context of oncology, where care does not come cheap and its associated toxicities—both financial and clinical—can have a substantial impact on patient quality of life. But efficient collaboration among primary care providers, oncologists, and other care team members is crucial to ensure patients with cancer receive the best…
Recent data indicate that the US is still lagging behind peer countries on maternal health and well-being, with comparatively worsened maternal mortality, preterm birth, chronic disease burden, and unaffordable health care costs among birthing people. Related inequities in severe maternal morbidity, preterm birth, neonatal intensive care unit (NICU) admission, and postpartum readmission only tell part…
What You Should Know: – Independent research reveals family physicians with 75% revenue derived from value-based payment models decrease burnout symptoms, according to a new study from Elation Health, and American Academy of Family Physicians (AAFP) Innovation Lab. – The goal of the study, conducted by surveying 10 primary care practices of varying sizes, was to…
The Centers for Medicare & Medicaid Services (CMS) introduced the Risk Adjustment Factor (RAF) model in 2004, which was designed to estimate future healthcare costs for patients. RAF scores are a critical component of value-based care, as they help predict healthcare resource utilization while adjusting for quality and costs for patients. With the introduction of the v28 HCC…
The Global and Professional Direct Contracting Model for Performance Year 2022 saved the Centers for Medicare and Medicaid Services $371.5 million and saved direct contracting entities $484.1 million, according to the agency’s first evaluation report of the model. This represents an increase from $70.4 million in savings to CMS and $46.5 million in net savings…
Value-based care has been a buzzword for decades in behavioral health, but the bulk of providers have yet to make the leap from fee-for-service to a risk-bearing or even cost-savings model. This could be changing as payers begin to prioritize value-based care contracts. In turn, this could reshape dynamics between providers and their investor partners….
Download Slides The Centers for Medicare and Medicaid Services (CMS) is displaying a strong commitment to transitioning the healthcare system towards 100% value-based care (VBC) by 2030. This ambitious goal signifies a significant shift from the traditional fee-for-service model to value-based payment models. The move towards VBC is driven by the increasing recognition of…
In 2023, the US witnessed the most considerable upsurge in refugee arrivals since 2017. Notably, major urban areas such as New York City and Chicago have experienced a recent influx of asylum seekers, straining city resources to provide adequate care. This has, in turn, inflamed existing debates among policy makers regarding the extension of health…