What Hospital Success Looks Like Under Value-Based Care

June 22, 2022acoHospitals, vbc

Hospitals are increasingly turning to value-based care initiatives to transform care delivery, lower the total cost of care, and improve patient outcomes. Unlike traditional fee-for-service (FFS) models that reimburse providers based on volume (i.e., the number of patient visits), providers are reimbursed based on the quality of care delivered in value-based care. Ultimately, success under…

5 Ways to Leverage Tech for Hospital Success Under Value-Based Care

May 31, 2022acohealth tech, Hospitals, vbc

Incentivized by the Centers for Medicare & Medicaid Services (CMS) to transform care delivery to improve outcomes, healthcare stakeholders are increasingly turning to value-based care initiatives. Outcomes are now contingent on providers working together across the continuum for shared goals, but hospitals are often not equipped with the resources necessary to do so. That’s where…

Everybody’s Talking About Value-Based Health Care. Here’s What They’re Not Saying.

April 12, 2022acoHospitals, Specialists, value-based care, vbc

Attend any healthcare conference and you’ll quickly discover that it’s become downright fashionable for healthcare leaders to talk about their unwavering commitment to “value-based care.” The expression has become ubiquitous in healthcare circles. Its virtuousness goes unchallenged. But should that be the case? Michael E. Porter and Elizabeth Teisberg (with whom I worked as a…

Growth in Health Information Exchange With ACO Market Penetration

January 17, 2022acoACO, ACOs, care coordination, health information exchange, HIE, Hospitals, Interoperability

Accountable care organization (ACO) success depends in part on a broad network of health information exchange (HIE) partners to effectively coordinate care. Our study illustrates that although ACO participation broadens HIE networks, the effects accrue differently across markets with varying levels of ACO penetration. ACO hospitals in high–ACO penetration markets increase their HIE network breadth…

How hospitals can use Z codes to track social determinants of health

October 8, 2021Garrett SchmittNo CommentsCMS, documentation, Hospitals, ICD, ICD-10-CM, SDOH, social determinants of health, Z code documentation, Z codes

Z codes, which are ICD-10-CM codes used to identify non-medical factors that may affect a patient’s health status, are a useful way to track social determinants of health and capture standardized data for Medicare beneficiaries. However, they are underused, with Z codes reported from only 1.59 percent of beneficiaries in 2019, according to a new…

Value-Based Payment Models May Help Hospitals Prepare for Surges

October 7, 2021Garrett SchmittNo CommentsCoronavirus, COVID-19, COVID-19 pandemic, hospital surges, Hospitals, pandemic, payment models, value-based care, value-based payment, value-based payment models, vbc

Hospitals and health systems can implement value-based payment models to ensure preparedness for seasonal and pandemic capacity surges, according to industry experts. Hospitals experienced increased demand for tangible resources and staff during the COVID-19 pandemic, demand health systems typically only face during peak flu season. Unlike organizations in other industries, hospitals and health systems tend to lose…

To Advance Health Equity, Measure Hospital Malnutrition Care

October 6, 2021Garrett SchmittNo CommentsBiden administration, CMS, Global Malnutrition Composite Score, health equity, healthcare equity, hospital malnutrition care, Hospitals, IQR, malnutrition, malnutrition care

Despite claiming to have prioritized health equity, the Biden administration just missed an opportunity to address poor nutrition—an important health and equity issue for older adults in particular. When the Centers for Medicare and Medicaid Services (CMS) recently released its FY 2022 Hospital Inpatient Prospective Payment System Final Rule, something was conspicuously absent from the Hospital…

Small Providers Unlikely to Abandon Fee-for-Service Reimbursement

September 20, 2021Garrett SchmittNo Commentsalternative payment models, APMs, fee-for-service, healthcare providers, Hospitals, value-based care, vbc

Fee-for-service reimbursement is still an integral part of the healthcare system as providers are scattered along a spectrum of payment models, Emily Sokol, director of research at Xtelligent Healthcare Media, explained on Healthcare Strategies. An Xtelligent Healthcare Media Insights report shed light on how pervasive fee-for-service reimbursement models are in today’s healthcare system. Over 200 providers responded to…

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…

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