One Big Beautiful Bill Act — What physicians need to know

July 7, 2025acoCMS, MA, MACRA, Medicare Advantage

On July 4, President Donald J. Trump signed into law the legislation and spending plan known as the One Big Beautiful Bill Act (OBBBA). The bill has a number of effects across different sectors of the economy, including health care. This slideshow compiles some facts, figures and responses from a variety of sources that analyzed…

A decade of value-based care: Tammy Schaeffer, JD, RN

June 30, 2025acoCMS, MA, MACRA, Medicare Advantage

A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. In July, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been and what…

Is ‘value-based care’ ill-defined?

June 4, 2025acoMA, skilled nursing facilities, SNF, SNFs

“Value-based care” (VBC) is one of the most frequently cited goals in U.S. healthcare reform — yet its meaning remains frustratingly vague and often contradictory. We hear that value-based care is the future. But as we navigate payment reforms, new quality programs, and evolving care models, we’re forced to ask: Whose definition of “value” are we…

The ‘price’ of value-based care

May 14, 2025acoMA, skilled nursing facilities, SNF, SNFs

The term “value-based care” is tossed around like a political football among healthcare policy makers. Nowhere is the meaning of this so variable as in nursing homes. The Nursing Home Value-Based Purchasing Demonstration project, completed over a decade ago, was not found to lower spending or improve quality. Webster’s Dictionary defines value as “the monetary worth of something,”…

SNF benchmarking study paints rosy picture for value-based care, I-SNPs this year

February 4, 2025acoMA, skilled nursing facilities, SNF, SNFs

A new report is highlighting continuing trends and areas of opportunities that skilled nursing providers can consider while addressing persistent industry developments, such as increasing implementation of Medicare Advantage plans and a hyperfocus on value-based care. The trends unveiled in accounting firm Plante Moran’s “2025 Skilled Nursing Facility Medicare Benchmarking Report” should be used as…

Value-Based Care and Fee-For-Service: What’s the Difference?

July 25, 2023acoACA, AMA, FFS, HEDIS, MA, Medicare Advantage, NCQA

In an effort to improve care quality and lower costs, the healthcare industry has been working on shifting from fee-for-service to value-based care delivery. The two models differ in the way providers are reimbursed for the care they provide by rewarding them service-by-service or based on overall quality and patient outcomes. In the following article, HealthPayerIntelligence breaks…

How Payers Can Identify Providers for High-Performing Networks

July 12, 2023acoACA, MA

Enrolling in the right health plan can significantly influence healthcare costs and consumer health outcomes. Despite significant healthcare spending, the United States has the worst health outcomes among high-income countries. In 2021, the US spent 17.8 percent of gross domestic product on healthcare, nearly twice as much as the average high-income country, a study from the Commonwealth…

What’s driving the transition to value-based care?

April 19, 2022acoACOs, MA, Medicare, Medicare Advantage, Risk, value based, vbc

The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus the…

Value-Based Payment Models Associated with Lower Acute Care Use

March 22, 2022acoAPMs, FFS, MA, Medicare Advantage, Physician Compensation, value-based payment

Medicare Advantage beneficiaries whose primary care organization participated in a value-based payment model saw lower rates of hospitalizations, observation stays, and emergency department visits, according to a study published in JAMA Network Open. Value-based payment models incentivize providers to deliver quality care while keeping healthcare spending low. As stakeholders see positive results, Medicare and Medicare Advantage plans have shifted toward…

Health Plan Investment in Social Determinants of Health Likely to Accelerate

August 5, 2021Garrett SchmittNo Commentshealth plans, MA, Medicare Advantage, NORC, SDOH, social determinants, social determinants of health

In recent years, Medicare Advantage (MA) plans have increasingly turned their attention to addressing members’ social determinants of health (SDoH), with the home playing a crucial role. That’s according to a new report from NORC at the University of Chicago. NORC conducted the report on behalf of Better Medicare Alliance’s (BMA) Center for Innovation in…

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