Alternative payment models that put financial risk on healthcare providers improved care quality for patients with diabetes more so than fee-for-service and incentive payment programs, according to a new study published in Health Affairs. “Models that place greater financial risk on providers, such as global payment and shared savings, tend to demonstrate greater improvements in…
How you ramp-up to full-scale APMs is crucial. Even if your multi-specialty group or health system receives some value-based payments with downside risk, your success hinges both on financial viability and retention of your clinicians and patients. If you delay APM adoption only after reviewing the potential on your bottom line, you’ll need to pay…
After years spent transforming your health care technology, you may feel like you’re almost done. But Value-Based Care Technology requires a different mindset. With reimbursement scaling to a tipping point for APM adoption, think “reboot” instead. Your health system or group has a long way to go if your aggregated and integrated data cannot support…
The Medicare Payment Advisory Commission (MedPAC) proposed streamlining Medicare alternative payment models (APMs), along with policy options for tackling pricey Part B drugs, in its June report to Congress Wednesday. In the June 2021 report, MedPAC called for reducing the number of Medicare APMs so that models running concurrently could work better together. The 2022…
Now that you’ve made the decision to start your path to Alternative Payment Models (APMs), what’s the first thing you need to consider? Hint: APM revenue calculation does not top the list. Obviously, APM revenue generation vis-à-vis traditional Fee-for-Service is critical. But those calculations assume constancy of two essential “assets”—clinicians and patients. Your competition is…
Health care has been suffering for a while—just ask any participant, including patients. You will hear about burnout, pressures to perform, changes in the market, pressures of new technology, fiefdoms, consumerism, and to top it off, the buildup of competition between traditional health care enterprises and new corporate health care businesses. Then there’s the pandemic,…
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. These value-based…
Value-based payment models that shared five-year expected savings offered stronger incentives for clinicians to implement preventive interventions for postpartum depression compared to models that offered shared savings over just one year, according to a study published in JAMA Network Open. The Affordable Care Act requires most commercial health insurance plans to cover preventive services for pregnant or postpartum…
François de Brantes is senior vice president of Episodes of Care at Signify Health and has been designing and implementing value-based payment programs for over a decade. For Signify Health, he leads customer development of Medicare Advantage, self-insured employer, and commercial payer markets. In this interview, Mr de Brantes discusses alternative payment models, advancing value-based…
Medicare Advantage beneficiaries whose primary care organization participated in a value-based payment model saw lower rates of hospitalizations, observation stays, and emergency department visits, according to a study published in JAMA Network Open. Value-based payment models incentivize providers to deliver quality care while keeping healthcare spending low. As stakeholders see positive results, Medicare and Medicare Advantage plans have shifted toward…