Many healthcare systems have made creating high-quality and value-based care a top priority. Southwestern Health Resources (SWHR) used clinical data and predictive analytics to put a total cost of care plan in place to provide affordable and quality care to thousands of patients in North Texas and cost-effective care for their employers. Oftentimes in the healthcare market, purchasers…
The COVID-19 pandemic has shone a light on the grave consequences of underinvestment in primary care and primary care research. Although we have known for decades that health systems with a strong foundation in primary care can improve access to care, health outcomes (including reduced mortality), and health equity, important work remains to be done….
The way to determine the quality of a Medicare Advantage health plan is simple: look at the five-star rating on the Medicare website. However, the Medicare Advantage Star Rating methodology that produces that star indicator is much more complex. A Medicare Advantage plan is a private payer health plan which the federal government funds and…
Health information exchanges (HIEs) advance interoperability and provide clinicians with greater access to patient health data for care coordination, according to an op-ed published in the Journal of AHIMA. Chris Hobson, MD, chief medical officer at Orion Health, and Allen Ausford, MD, FCFP, a clinical professor in the Department of Family Medicine at the University of Alberta,…
Better Merit-based Incentive Payment System (MIPS) quality scores were rarely associated with lower rates of hospital complications during the first year of program implementation, according to a study published in JAMA Network Open. Researchers studied a cohort of over 38,000 specialty physicians using CMS’s Physician Compare and Hospital Compare data from 2017, the first year…
For Sutter Independent Physicians (SIP), patient satisfaction surveying was a fragmented process. According to the independent physician association (IPA), giving practices actionable insights about the patient experience that could yield effective practice improvement efforts had long been a challenge. That is, until the organization tapped point-of-care patient satisfaction surveying. “Our aim really is to work…
Although accountable care organizations (ACOs) have never been particularly popular among skilled nursing facilities, timing may be ripe to take on more risk to stay competitive in the market. ACO participation may help operators maintain referrals when so many potential residents are being diverted to home health care, hospice and other tracks along the continuum…
The number of Medicare Advantage plans investing in supplemental benefits to address social determinants of health tripled in a single year, but additional guidance and standards from the Biden administration are needed, a new report said. The report, released Thursday by the Better Medicare Alliance, comes as the Biden administration has made it a priority…
Extensive research and the pandemic have elevated the importance of addressing social determinants of health (SDOH) to improve health and reduce longstanding disparities in health and health care.1 Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Prior…
As Medicare Advantage continues to serve a proportionally higher-risk and more diverse enrollment population, a new report highlights innovative approaches to addressing social determinants of health (SDOH) for Medicare Advantage beneficiaries, while acknowledging barriers that remain. Social determinants of health are non-medical factors that account for up to 55% of an individual’s health outcomes, according…