As we look toward brighter days post-pandemic, we would be remiss to not reflect on how COVID-19 has challenged healthcare providers, both clinically and financially. While COVID-19 infections have declined, providers have learned from the turbulence of the past year that being prepared to think strategically about their business is critical to providing affordable, quality…
Members of the U.S. House of Representatives this week introduced bipartisan legislation to strengthen Medicare’s value-based care models and accountable care organizations (ACOs), among other alternative payment models (APMs). Doctors, hospitals and other providers make up an ACO — the group coordinates care for Medicare patients while limiting extraneous services and preventing medical errors. The better…
On July 9, the Office of the National Coordinator for Health Information Technology (ONC), the federal agency that oversees health information technology, announced a long-awaited change that could help doctors and nurses provide better, more timely care for their patients. The agency released an updated version of the U.S. Core Data for Interoperability (USCDI), a…
Over the last ten years, policymakers of both parties have identified health care payment reform as a critical national priority. Payment incentives offered by Medicare and other large payers create the environment in which providers must choose between being rewarded for performing more services and procedures, as in fee-for-service medicine or, for efficiently managing the…
Southwestern Health Resources (SWHR) is an integrated health care network formed in 2015 with the purpose of filling gaps in care. It’s also part of one of the top Next Generation Accountable Care Organizations (ACOs) in the nation. Having an unwavering commitment to lowering “total cost of care” has been a main factor in that…
Specialists are key partners for delivering value-based care, particularly for patients with chronic diseases. This involves the appropriate diagnosis of conditions, including rare diseases, stewardship of diagnostics and value-based prescribing for specialty medications. Lawrence Kosinski, M.D., MBA, founder and chief medical officer of SonarMD, a tech-enabled care coordination solution for digestive health, notes the great…
Understanding the full impact of the COVID-19 pandemic on the healthcare industry is not yet possible, but a few outcomes are evident. Medicaid and Affordable Care Act (ACA) enrollment rates are surging alongside the unemployment rate.1 In addition, postponed procedures and delayed routine services—as well as pent-up demand for elective procedures—will soon drive increased utilization….
The economic fallout related to the COVID-19 pandemic has yet to hit healthcare, but the result is likely to be an amplification of longstanding disparities within the U.S. healthcare system. Factors such as food insecurity, homelessness and access to care can affect a staggering 80% of patient outcomes. There is no single solution, and healthcare providers…
New bipartisan House legislation aims to boost the amount of shared savings that accountable care organizations can receive from the federal government to halt a slide in participation that has occurred over the past two years. The Value in Health Care Act reintroduced on Tuesday includes new requirements to study health outcomes for Medicare beneficiaries…
Download Slides What distinguishes a high performing Accountable Care Organization (ACO) from a low performing one? Is there a list of key ingredients that can predict success? While the answers to these questions are not simple, it is important for any value-based organization to understand what the right levers are that impact the greatest…