What does the future hold for health care payment reform models? Tornadoes form when high-speed winds rapidly change direction around a thunderstorm, causing the air to swirl horizontally. The swirling air picks up warmer air from the ground, creating a funnel that grows longer and longer; when it touches the ground, it becomes a tornado. …
The Center for Medicare and Medicaid Innovation has announced that 51 provider and accountable care organizations are participating in direct contracting, the new risk model that has evolved from Next Generation. The implementation period, which began in October and runs through March 31, 2021, provides time for the direct contracting entities to prepare for the first performance…
The challenges that ACOs regularly face rarely travel alone – they come as a package deal, feeding off of each other and creating a seemingly insurmountable situation. When Genesis Physicians Group decided to partner with Innovista Health Solutions in 2017, its single value-based contract, a Medicare Advantage product, was struggling to meet its performance…
Health systems looking for the right balance between telehealth and in-person care shouldn’t think of one service as a replacement for the other. Rather, they should be complementary. That’s the strategy being used at Sutter Health. And Chris Waugh, chief innovation officer at the California-based 24-hospital network, says that strategy will come into play more…
Back in June we conducted a webinar titled Power Over Uncertainty – Five Steps for ACOs to Take Now, where we outlined five steps we suggested ACOs take to improve quality outcomes, while also ensuring organizational sustainability. With CMS’s release of the 2020/2021 Shared Savings Quality Measure Benchmarks this month, I wanted to share some of my insights…
The Trump administration on Thursday issued its final rule requiring nearly all health insurers and self-insured plans to disclose pricing and cost-sharing information. The Transparency in Coverage rule will force employer health plans and insurance companies to post in-network and out-of-network rates they negotiate with providers. It also requires insurers to develop online price transparency tools…
The COVID-19 pandemic has upended every sector of the economy. Within health care, the pandemic has prompted dramatic innovation but also deeply disrupted the practice of medicine. To meet the demands of the initial COVID-19 surge, and to protect patients and staff, health care facilities across the country canceled elective procedures and outpatient visits. Patients, fearful of contracting…
Being able to centralize and make use of data from multiple payers is difficult to do. As a result ACOs have to use multiple systems to analyze data and provider performance is not easily compared across payers. In this presentation, learn about the benefits that come as a result of being able to access…
Although risk-based care contracts have existed for many years, primary care doctors have been reluctant to embrace them. But with careful planning, these contracts can offer medical practices the flexibility and income they need to provide high-quality care, while maintaining their independence. Representatives of practices using value-based payment contracts discussed their benefits during a session…
For countless individuals across the United States and the world, the outbreak of the COVID-19 pandemic prompted a rapid shift to digital life. In the healthcare industry, the sudden need to reduce patient travel and exposure while preserving provider capacity resulted in an unprecedented increase in the adoption of telemedicine. Within a matter of days,…