What is person centered care?

October 14, 2021Garrett SchmittNo CommentsCost Reduction, customized care, health outcomes, person centered care, person-centered, SDOH, social determinants of health

Person-centered care is a framework that healthcare payers and providers use to ensure care plans address the full spectrum of health-related needs that members face, including medical, behavioral, and social determinants of health (SDOH).  In contrast to other models of care, a person-centered approach to care recognizes that each member deserves a care plan that…

AI: The Next Frontier for Healthcare Providers

July 6, 2021Garrett SchmittNo CommentsAI, Cost Reduction, health data, healthcare technology, patient outcomes

The pace of change in the healthcare industry is accelerating with new therapies promising cures to previously debilitating or deadly diseases. Aging populations, and public health crises, such as addiction to opioids, are putting pressure on provider workloads and increasing patient safety risk and negatively affecting patient experience.  Healthcare providers must rise to the challenges…

What is value-based care?

June 16, 2021Garrett SchmittNo CommentsAPMs, Bundled Payments, Cost Reduction, MIPS, pay for performance, SDOH, shared risk, Shared Savings, value-based care, vbc

Value-based care (VBC) is a crucial step towards improving access, equity, and quality healthcare for Americans. Since the inception of Blue Cross Blue Shield in the 1930s, the US healthcare system has relied primarily on fee-for-service (FFS) payment practices. Essentially, you go to the doctor for a specific need, the doctor serves that specific need,…

A Decade of Value-Based Payment: Lessons Learned And Implications For The Center For Medicare And Medicaid Innovation, Part 1

June 9, 2021Garrett SchmittNo CommentsACOs, APMs, CMS, Cost Reduction, COVID-19, Fee for service, health spending, organization of care, payment, payment models, value-based payment, value-based purchasing, vbc

Over the past decade, adoption of value-based payment (VBP) models has increased substantially. The Center for Medicare and Medicaid Innovation’s has launched multiple new models since its authorization, commercial payers have structured almost one-third of their payments as alternative payment models (APMs), and state Medicaid programs have increasingly included payment reforms in their waivers and…

ACOs using medical home physicians save money, yield higher quality, report finds

August 8, 2018Garrett SchmittNo CommentsCost Containment, Cost Reduction, Medical Home, PCMH

Dive Brief: Medicare ACOs with a higher proportion of primary care physicians with patient-centered medical home experience were more likely to generate savings and demonstrate higher quality scores, according to the Patient-Centered Primary Care Collaborative’s (PCPCC) 2018 Evidence Report. Researchers grouped 333 ACOs into quartiles from no PCMH experience (Q1) to 43% PCMH primary care physicians…

Shorter behavioral stays save Medicaid money, but frustrate hospitals

August 1, 2018Garrett SchmittNo CommentsBehavioral Health, Cost Containment, Cost Reduction, hospital, Hospitals, Medicaid, Medicaid ACOs

The shift toward value-based payment in healthcare that countless advocates say will cut costs and improve the quality of care isn’t without its downsides. This week’s earnings show the evolution is weighing on some providers’ bottom lines. As more of Universal Health Services’ behavioral health patients move from fee-for-service Medicaid to Medicaid managed-care programs, the…

Secret team to ‘kill the old healthcare model’ launches at Florida Hospital

July 24, 2018Garrett SchmittNo CommentsCost Containment, Cost Reduction, hospital, Hospitals, vbc, VBHC

Orlando-based Florida Hospital President and CEO Daryl Tol said during a recent talk that the hospital has created a secret team called Project Fulcrum to “kill the old healthcare model,” according to the Orlando Sentinel. Here are three things to know: 1. Mr. Tol, who also serves as president and CEO of the central Florida…

ACOs With Risk-Bearing Experience Are Likely Taking Steps to Reduce Low-Value Medical Services

July 17, 2018Garrett SchmittNo CommentsACOs, Cost Containment, Cost Reduction, low value, Risk, Risk Bearing, Survey

ABSTRACT: Objectives: Accountable care organizations (ACOs) are groups of healthcare providers responsible for quality of care and spending for a defined patient population. The elimination of low-value medical services will improve quality and reduce costs and, therefore, ACOs should actively work to reduce the use of low-value services. We set out to identify ACO characteristics…

Cost containment is a top priority among health system executives

July 11, 2018Garrett SchmittNo CommentsCost Containment, Cost Reduction

When Rob Lazerow, a managing director at the Advisory Board Co., recently met with the executive team of a large health system, he noticed a construction project had been downsized from the prior year. The organization decided to replace its aging facilities with smaller structures, which would potentially allow it to fine-tune its staffing model…

Value-Based Payment Adoption Drives 5.6% Reduction in Care Costs

June 18, 2018Garrett SchmittNo CommentsCost Reduction, Patient Engagement, value based, Value based contracts, Value Based Reimbursement, VBHC

Payers that implemented value-based payment models reduced healthcare costs by an average of 5.6 percent, improved provider collaboration, and created more impactful member engagement, according to a new study from Change Healthcare. The Finding the Value: The State of Value-Based Care in 2018 report, presented at the 2018 AHIP Expo, found that payers are effectively…

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