For organizations hoping to draw out savings from value-based care, added administrative burdens might be a source of hesitation. However, some operators are successfully turning to technology offerings that maximize reimbursement, pinpoint essential data, and include platforms already used by referral partners and managed care organizations (MAOs). AI programs can help “tease out” some of…
The future of value-based care programs will likely focus on greater integration of care, as nursing homes and other providers in the health care continuum discover the benefits of more thoughtful discharges – less focused on swiftness and more on moving patients through a continuum of care – in order to close costly gaps in…
Download Slides Discover the keys to mastering value-based care contracts in this informative webinar! Join industry experts as they delve into effective strategies for contract negotiations, year-round performance tracking, and actionable approaches to streamline contract management in value-based arrangements. Gain valuable insights into measuring and comparing performance across multiple contracts to ensure alignment with…
The Centers for Medicare & Medicaid Services (CMS) announced today that the Medicare Shared Savings Program (Shared Savings Program) continues to save Medicare money while supporting high-quality care. The Shared Savings Program yielded more than $2.1 billion in net savings in 2023 — the largest savings in the Shared Savings Program’s history. In addition, Shared…
Download Slides Value-based care (VBC) arrangements between payers and providers continue to grow, fueled by the Center for Medicare and Medicaid’s (CMS’) ambitious goal of achieving 100% accountable care for Medicare beneficiaries by 2030. To be successful under these arrangements, provider organizations need to understand the VBC landscape and the levers they have available…
Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is “empowering consumers with the…
Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is to “empowering consumers with the necessary…
Background: The Center for Medicare & Medicaid Services’ Center for Medicare & Medicaid Innovation tests service delivery models designed to improve care quality and patient outcomes while reducing or maintaining program costs. Historically, Innovation Center models were not explicitly designed to serve underserved populations, and most evaluations have not focused on health equity-related outcomes. In…
A Medicare Advantage bundled payment model for hip and knee replacements offered by Humana (NYSE: HUM) was associated with reduced skilled nursing facility use. These bundled payments were also linked to reduced spending overall for lower extremity joint replacements (LEJR) – while maintaining quality of care, according to a study published in JAMA Network. Of…
It’s no secret that something needs to be done in order to curb the unsustainable increase in Medicare spending. In 2021, overall Medicare cost grew 8.4%, or 21% of total national health expenditure, greatly exceeding the pace of economic expansion and in turn threatening the long-term financial viability of the program. The Centers for Medicare & Medicaid…