At the beginning of this series, we laid out a basic tenet: As shared savings plan ACOs, you need to do as well or better at lowering costs than competing value-based payment models. Otherwise, your resources and support will dwindle in favor of more promising avenues to control Medicare spending, and competition will stifle your…
HealthEC offers a KLAS-recognized, end-to-end population health management platform designed to help ACOs succeed with value-based care. Our HealthEC CareConnect® generates personalized, clinically-proven plans that enable teams, including community-based resources, to deliver patient-centric care. Advisory services are also available to guide our ACO partners in defining their strategic goals as they transition from volume…
Accountable care organizations (ACOs) can improve health equity in their patient populations, but they need more funding and flexibility to do so, according to a report from a group representing 370 ACOs. “ACOs are already beginning to do the work of addressing negative [social determinants of health] to improve quality and control costs for the…
Providing timely, high quality, patient care is no easy feat. In fact, as the healthcare industry continues the shift toward value based care, this job becomes more complex, with growing requirements to monitor the outcomes of both individual patients and the greater patient population into which they fall. The movement away from fee-for-service, however, doesn’t have to…
The world of healthcare is quickly migrating from a fee-for-service (FFS) reimbursement model to value-based care. But for accountable care organizations (ACOs) comprised of multiple independent providers, making the transition to value-based care can be especially complex. Working with disparate electronic medical records (EMRs) across a wide range of care settings and specialties, these organizations…
The Affordable Care Act was passed in 2010 with the goals of controlling healthcare costs and decreasing the number of people without health insurance. While progress has been made to expand coverage (the percentage of uninsured Americans dropped from 17% in 2003 to 12% in 2018), overall expenditures continue to rise. In the United States today, healthcare…
In 2013, Earnest Carter, MD, deputy health officer of Maryland’s Prince George’s County Health Department, sought and received grant funding to improve population health in the community. His vision was to involve various local stakeholders and focus on social issues impacting an individual’s ability to live a healthy life. In 2016, Prince George’s partnered with…
Two macro trends are converging to further season and ultimately catalyze the transformation of the American healthcare enterprise: the predominant fee-for-service model that fuels the provider ecosystem (hospitals, health systems, medical groups, IPAs, ACOs, or managed physician networks, etc.) and their ‘partner’ financing plans, payors or administrators. Ecosystem incumbents include national or regional commercial health insurers…
To achieve quality health outcomes, organizations must deliver excellent patient care. However, patients may suffer poor outcomes – even if they have access to the best care in the world – if providers fail to consider social determinants of health, including factors such as socioeconomic status, education, social network support, access to care, access to…
Effective population health management is beginning to require healthcare providers to rely heavily on big data derived from both their own health IT systems and from their business partners. Identifying patients at high risk of developing chronic diseases or falling away from maintenance protocols is a significant challenge for many organizations, but is quickly becoming…