Understanding the full impact of the COVID-19 pandemic on the healthcare industry is not yet possible, but a few outcomes are evident. Medicaid and Affordable Care Act (ACA) enrollment rates are surging alongside the unemployment rate.1 In addition, postponed procedures and delayed routine services—as well as pent-up demand for elective procedures—will soon drive increased utilization….
The economic fallout related to the COVID-19 pandemic has yet to hit healthcare, but the result is likely to be an amplification of longstanding disparities within the U.S. healthcare system. Factors such as food insecurity, homelessness and access to care can affect a staggering 80% of patient outcomes. There is no single solution, and healthcare providers…
After the 2020 election, we predicted seven trends to expect in Value-Based Care. Our forecasts were right on track. Last week the Biden Administration released its first Physician Fee Schedule and Quality Payment Program Proposed Rule, a 1,747-page document that promotes restructured value-based care initiatives. As we predicted, it recognizes both a significant health equity…
The American Medical Group Association (AMGA) recommended several steps regarding accountable care organization (ACO) financial risk advancement in the Medicare Shared Savings Program (MSSP) in a letter to CMS. CMS’ decision to defer the automatic advancement of ACOs in the MSSP and allow ACOs to remain in their current risk level of the BASIC Track’s…
Value-based care has been on the horizon for years. Providers that were ready to leverage digital tools to deliver care remotely experienced success when the payment model finally took hold during the early days of the pandemic. “When we look at the pandemic and how hospitals performed financially, it’s those hospitals that had already started…
As the pandemic eases and state public health emergencies expire, healthcare providers are scrambling to figure out what they can and can’t do with telehealth any more. Florida Governor Ron DeSantis allowed his state’s state of emergency to expire this past weekend after extending it several times, ending a number of emergency measures aimed at…
Accountable care organization (ACO) growth has hit a snag again, with the COVID-19 pandemic impacting the number of ACOs in public and private contracts, according to a new analysis. The analysis published in the Health Affairs blog found that ACO growth has plateaued over the last couple of years, starting in 2019 when CMS introduced…
Social isolation, a key social determinant of health (SDOH) can have a negative effect on mental and physical health outcomes. Individuals in long-term care (LTC) facilities have higher 30-day mortality rates when the facility is in a socially isolated location, according to a study from the Journal of American Medical Association (JAMA). Since the coronavirus…
The healthcare industry in the U.S. has spent a whole generation talking about moving from a fee-for-service to a value-based model, focusing more on improved patient outcomes and early interventions rather than disease treatment. This shift has occurred gradually, sometimes purposefully, and sometimes in fits and starts, but overall, it has been slower than expected….
To say that hospitals and health systems have had to do more with less in the past 18 months is the understatement of a lifetime. These organizations have faced more than their fair share of unexpected challenges – from spiking patient demand, increasing costs and lost revenue, to overworked staff, a downturn in elective procedures…