Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population. CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically…
If you’re scratching your head about the direction of Value-Based Health Care (VBHC) in Medicare, you’re not alone. The current mix includes a swirl of separate initiatives, some new and others recently re-labeled. As CMS pushes toward VBHC, providers may feel confused and frustrated as concepts emerge that will affect multiple programs. Within the last…
Accountable care organizations, are a new organization of healthcare, combining some aspects of insurance and health systems. They are collaborations which are paid a capitated rate, based on risk, and provide all care to these beneficiaries. If they show savings beyond what they are paid, they receive about half as an “incentive.” Savings cannot be…
We strive here to explain in one narrative the key aspects of APMs, as updated for the 2018 performance year, both for those new to APMs as well as those with previous familiarity. The FAQs are optimally read in sequential order but are also sufficiently standalone (with linking across FAQs) to enable skipping to the…
It was my first bereavement group meeting. One after another, people recounted heart-wrenching tales full of tears, anger, regret and loneliness over the loss of their spouse. Their partners had died in hospitals, with medical personnel trying to work miracles right up to the bitter end. They did not feel good about their spouses’ medical…
Few healthcare organizations are investing in social determinants of health technology, and while an uptick is expected, the market will remain relatively weak until providers find the best way to use the data, according to a new analysis from Patchwise Labs. The report found that fewer than 4% of health systems and managed care organizations…
Medicare’s bundled payment programs are in an opportune position to produce additional savings and create a more cost-effective public payer program with certain revisions, a new white paper from USC Brookings explains. CMS’s current bundled payment programs would achieve greater cost effectiveness by extending acute hospital reimbursement and hospital-based bundled payment episodes, argued John A….
From innovative connected care platforms to the Internet of Things, telehealth is showing today’s seniors (and tomorrow’s soon-to-be seniors) how they can live out their golden years in their own homes. The projected surge in Baby Boomer seniors, combined with an overtaxed healthcare system running short on doctors and nurses, is helping to put the…
When we talk about “value” in Value-Based Health Care (VBHC), we’re referring to the high-quality/lower-cost services that buyers want from health care providers. Who are the buyers? Health plans, Medicare and other governmental purchasers, plus employers (for the most part, the term is notably not interpreted to include patients). What do buyers want? “Truth in…
A unique arrangement between Blue Cross Blue Shield of Arizona and Change Healthcare reported shared savings on Tuesday. The independent, physician-centric accountable care organization called ACO Partner said it is is giving $148,000 to 148 physicians who earned shared savings in the program during the fourth quarter of 2016. Established in 2016, ACO Partner is…