Direct provider contracting (DPC) is coming to Medicare. Under a new announcement about reforming health care payment and delivery, the Centers for Medicare and Medicaid Services (CMS) has announced forthcoming DPC models as part of the effort to “deliver value-based transformation in primary care.” In particular, the agency seeks to implement models that enable it…
At the AHIP Institute & Expo in Nashville June 19-20, Becker’s Hospital Review asked 17 executives from health plans and providers one question: What is the future of the payer-provider relationship? Below, C-level leaders, presidents, vice presidents, directors and advisers from payers and providers nationwide share their perspective. Editor’s note: Responses have been lightly edited for length…
March 23, 2019, marked the ninth anniversary of The Patient Protection and Affordable Care Act (ACA) being signed into law. These past nine years have been a continuing debate regarding the various aspects of health insurance reform contained in the ACA. The most fundamental of reforms arose out of the simple definition of “essential health benefits.” For…
Evidence is mounting about the importance of robust primary care in achieving the Triple Aim of advancing quality of care, reducing costs, and improving the patient experience. Primary care initiatives across the country have shown that enhancing primary care can coordinate service delivery to the benefit of both patients and clinicians. In Medicare accountable care organizations (ACOs), primary…
Data is the catalyst for healthcare’s next revolution. Today’s healthcare providers and administrators have an incredible opportunity to participate in what may be the biggest societal shift of a lifetime: the move from a fee-for-service (FFS) payer model to value-based care (VBC). Effectively using data will facilitate that shift. On December 21, 2018, CMS issued…
While much of the attention this week from the Trump administration’s executive order on transparency focused on prices, there’s also a section of it that calls for alignment of quality measures across all federal healthcare programs. Provider stakeholders and quality researchers support the effort but say it will be a heavy lift. Tucked within the executive order, the…
The healthcare industry is moving beyond just the development and adoption of alternative payment models (APMs), according to Aparna Higgins, a former leader at the Health Care Payment Learning and Action Network (HCP-LAN). HCP-LAN is a public-private partnership that aims to accelerate the transition to value-based reimbursement and care through increased APM adoption. The organization…
Providers’ perspectives on Medicare accountable care organizations (ACOs) sharply shifted when the Centers for Medicare & Medicaid Services overhauled the program to mandate that all participants take on downside financial risk. “Now, they really have to know what they are doing; you can no longer fake it ‘til you make it and see what happens,”…
Click Here to Begin Presentation CareAllies works closely with providers to accelerate the transition to value-based care. You can increase your knowledge, and earn CME credits, through Valuable Insights, their free, online education series. In the What’s My Quality Score webcast, Erin DeLoreto, assistant vice president of value-based programs for CareAllies, explains how your Shared…
Click Here to Begin Presentation CareAllies works closely with providers to accelerate the transition to value-based care. You can increase your knowledge, and earn CME credits, through Valuable Insights, their free, online education series. In the Quality Payment Program webcast, Kathleen Gravelle, chief risk officer for CareAllies, provides an overview of the Medicare incentive program….