Common Utilization Measures That Impact Value-Based Care Efforts

July 20, 2023acoHEDIS, NCQA, Triple Aim, Utilization Management

Quality and quantity have a nuanced relationship in the healthcare system: put simply, payers want to reduce members’ quantity of low-value services while increasing the number of services that produce better quality care. As a result, utilization measures that track the use of high- and low-value care are critical to a value-based structure. The triple aims of value-based…

Value-Based Care: Operational Context Matters

June 30, 2023acoTriple Aim

The advent of value-based care, based on the Institute for Healthcare Improvement “Triple AIM” framework — improving the health of populations, reducing the per capita cost of care and improving the individual experience of care — has motivated providers to shift their focus from volume to value. And, as providers shift to value-based activities, their…

MGMA 2020: Transitioning to value-based care

October 21, 2020Garrett SchmittNo CommentsMGMA, Triple Aim

Although risk-based care contracts have existed for many years, primary care doctors have been reluctant to embrace them. But with careful planning, these contracts can offer medical practices the flexibility and income they need to provide high-quality care, while maintaining their independence. Representatives of practices using value-based payment contracts discussed their benefits during a session…

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