BMA: Number of MA plans offering social determinants of health benefits increased threefold in 2021

August 5, 2021Garrett SchmittNo CommentsBetter Medicare Alliance, BMA, Medicare Advantage, NORC, SDOH, social determinants, social determinants of health

The number of Medicare Advantage plans investing in supplemental benefits to address social determinants of health tripled in a single year, but additional guidance and standards from the Biden administration are needed, a new report said. The report, released Thursday by the Better Medicare Alliance, comes as the Biden administration has made it a priority…

Increase in Medicare Advantage Activity to Address Social Determinants of Health, But Barriers Still Remain

August 5, 2021Garrett SchmittNo CommentsCMS, HHS, Medicaid, Medicare Advantage, SDOH, social determinants of health, social needs, Star Ratings, Value-Based Insurance Design, VBID

As Medicare Advantage continues to serve a proportionally higher-risk and more diverse enrollment population, a new report highlights innovative approaches to addressing social determinants of health (SDOH) for Medicare Advantage beneficiaries, while acknowledging barriers that remain. Social determinants of health are non-medical factors that account for up to 55% of an individual’s health outcomes, according…

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…

Payer Gives Community-Based Social Determinants of Health Support

June 30, 2021Garrett SchmittNo CommentsAACN, Alamo Area Community Network, Bold Goal strategy, community, community health, Humana, Medicare Advantage, payer, SDOH

Humana’s Bold Goal strategy led to a 6.8 percent decrease in the number of unhealthy days for San Antonio members. A previous version listed 8.6 percent as the figure. Humana has partnered with a technology platform and a group of community-based organizations to address social determinants of health for Medicare Advantage members in San Antonio, Texas. Alamo…

Value-based care shift hits inflection point with tech and policy advancements

June 18, 2021Garrett SchmittNo Commentscare coordination, chronic kidney disease, CKCC, CKD, CMS, Comprehensive Kidney Care Contracting, COVID-19, Data, end-stage renal disease, ESRD, ESRD Treatment Choices, ETC, Medicare, Medicare Advantage, policy, technology, value-based care, vbc

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….

MedPAC: Overhaul MA payments and streamline CMMI models

June 16, 2021Garrett SchmittNo CommentsCMMI, FFS, high-cost drugs, MA, MACPAC, Medicare, Medicare Advantage, MedPAC

Two influential advisory groups sent recommendations to Congress calling for a revamp of how health plans are paid in the lucrative Medicare Advantage program, culling how many models CMS tests and curbing high-cost drug approvals. By many measures, the MA program has been thriving. Enrollment and participation has continued to grow, and in 2021, MA…

Data Analytics Gives Hospice an Edge in Value-Based Care

June 15, 2021Garrett SchmittNo Commentsclinical analytics, Data, Data Analytics, financial analytics, hospice, Medicare Advantage, patient data, patient outcomes, Referrals, vbc

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…

How to Avoid Falling From Grace: Strategies for MA Plans to Sustain & Improve Performance

May 4, 2021Garrett SchmittNo CommentsMA, Medicare Advantage

Having helped several Medicare Advantage plans achieve significant quality performance improvements (up to 1.1 stars improvement YoY in 2020 alone), Stellar Health (Stellar) is sharing its perspective on what it takes to sustain and improve Star Ratings for health plans and why there is a need for action despite even a few years of success….

Focus on Quality in Value-Based Care Could Impact Hospice M&A

April 28, 2021Garrett SchmittNo CommentsCMS, hospice, Medicare Advantage, private equity investors, vbc

A robust hospice mergers and acquisitions market is showing no signs of slumping as interest among strategic buyers and private equity investors ramps up. A provider’s performance within evolving value-based payment models may become a factor that potential buyers consider when eyeing a hospice acquisition, particularly as it pertains to their quality and outcomes data….

CMMI Chief Fowler: Value-Based Care at a Crossroads

April 20, 2021Garrett SchmittNo CommentsACOs, Biden, CMMI, CMS, Fowler, Geographic Direct Contracting, hospice, Medicare Advantage, Medicare Care Choices Model, MSSP, NAACOS, Primary Care First, Seriously Ill Population, vbc

The Center for Medicare & Medicaid Innovation (CMMI) remains committed to moving the health care system towards value-based care in the early years of the Biden Administration, though the center’s leadership is doing some soul-searching on how best to pursue its mission, according to CMMI’s new director Liz Fowler. Fowler made her first public remarks…

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