States that benchmark their healthcare cost growth improve transparency, strengthen primary care and boost alternative payment models, according to a new report. Eight states have implemented or are developing the regulatory and data gathering infrastructure to track annual healthcare cost growth, and more are expected to follow suit. Standardizing how those benchmarks are created and…
Hospice providers are increasingly turning to data analytics systems to gain an edge against competitors when engaging prospective referral partners, anticipating impacts in value-based care. Data are key to demonstrating the value of hospice to potential referral partners as evolving value-based payment models take effect. The value-based insurance design demonstration project, commonly called the Medicare…
Machine learning is getting better at predicting things. There are now algorithms that improve the detection of diabetic retinopathy, predict the onset of sepsis, and help determine a critically ill patient’s risk of dying. But a piece of wisdom from Warren Buffet comes to mind: “Predicting rain doesn’t matter. Building arks does.” Even the most…
The current pandemic will likely have significant negative long-term consequences on health, with the economic downturn, job losses, social and emotional effects of social distancing and sheltering, and disruption to routine health care and education. These pressures exacerbate the existing shortfall of investment in social determinants of health (SDOH). Looking ahead, finding mechanisms to unleash…
There is increased recognition for better methods to measure, predict and adjust for social risk factors in healthcare and population health. Current performance and quality measures generally do not take SRFs into account in the bonus/penalty structure, nor are SRFs generally included in most risk adjustment formulas. This can lead to unintended consequences, including the…
Nearly every chronic health condition has an increased prevalence with declining income; in fact, the life expectancy of the wealthiest American is ten to fifteen years longer than that of the poorest. Health disparities negatively affect people who experience larger obstacles to achieving optimal health due to lack of access to care. Healthcare systems face…
Dr Ahmed El Saeed, Focal Area Lead at the United Nations Global Pulse Finland, Executive Office of the UN Secretary-General, said: “International development is everybody’s business. You can do business and do good, and this is a message to the private sector, there is a very important role for the private sector to play in…
Roughly $4 trillion is spent on healthcare annually in the U.S. Despite this massive expenditure, roughly 80% of health outcomes are attributed to social, behavioral and environmental factors, known as social determinants of health (SDOH). What has been far less clear is how providers and payers can fully harness SDOH data to proactively manage the…
For managed-care plans focused on improving population health and reducing overall costs, the goal has to be on prevention, not just treatment. One increasingly popular strategy is targeting members based on social determinants of health (SDOH), which accounted for around $2.5 billion in spending between 2017 and 2019, according to a 2020 study. But how…
The health care media are full of articles asserting that ACOs have proven their mettle in delivering health care of highest quality. Citing ACO quality reporting results, CMS and advocates point to the majority of ACOs passing CMS quality standards, and that ACOs are improving their results on quality measures over time. The vast majority…