“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 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,”…
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…
The Centers for Medicare & Medicaid Services (CMS) introduced the Risk Adjustment Factor (RAF) model in 2004, which was designed to estimate future healthcare costs for patients. RAF scores are a critical component of value-based care, as they help predict healthcare resource utilization while adjusting for quality and costs for patients. With the introduction of the v28 HCC…
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. These value-based…
DOWNLOAD SLIDES Learn about the types of analytics available in post-acute healthcare and how they’re being used by ACOs to: Build and sustain high-performing SNF networks Prevent hospital readmissions and adverse events Reduce total cost of care and Earn more shared savings Speaker: Janine Savage, RN, CHC Vice President, Product Management, Analytics and Business Intelligence…
On August 11, 2020, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced the new Community Health Access and Rural Transformation (CHART) Model as part of the President’s recent executive order. The Model is an incredible accomplishment for patients and healthcare providers in rural areas that face social determinants of health (SDOH) challenges,…
Medicare accountable care organizations accepting downside financial risk will have easier access to CMS waivers of the rule requiring three-day inpatient stays before patients can be sent to skilled nursing facilities. In a guidance published Monday, the CMS laid out requirements for Shared Savings Program ACOs that apply for a waiver of the three-day stay rule. Only…
Inevitably, healthcare incentives continue to transition from the traditional fee-for-service (FFS) model to a value-based payment system. A recent modernization to how the Centers for Medicare & Medicaid Services (CMS) will pay providers for skilled nursing facility (SNF) performance is proof. And if you want to achieve success in alternative payment models (APMs), such as bundled payments…
Due to high magnitude and variation in spending on post-acute care, accountable care organizations (ACOs) are focusing on transforming management of hospital discharge through relationships with preferred skilled nursing facilities (SNFs). Using a mixed-methods design, we examined survey data from 366 respondents to the National Survey of ACOs along with 16 semi-structured interviews with ACOs…