The transition from traditional fee-for-service (FFS) payments to valuebased reimbursement models is fundamental to the future of healthcare. Rather than rely on the number of tests or procedures to inform financial reimbursement, value-based care (VBC) models incentivize providers to deliver on three components: improving the patient care experience, improving the health of populations, and reducing…
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….
To say that hospitals and health systems have had to do more with less in the past 18 months is the understatement of a lifetime. These organizations have faced more than their fair share of unexpected challenges – from spiking patient demand, increasing costs and lost revenue, to overworked staff, a downturn in elective procedures…
Value-based care (VBC) is a crucial step towards improving access, equity, and quality healthcare for Americans. Since the inception of Blue Cross Blue Shield in the 1930s, the US healthcare system has relied primarily on fee-for-service (FFS) payment practices. Essentially, you go to the doctor for a specific need, the doctor serves that specific need,…
Sustainable health care systems should be focused on outcomes instead of reimbursing for the services provided. Critical levers for accelerating this are patient engagement and a more comprehensive, standardized collection of patient outcomes. Also, more expertise is required on how these data can best be incorporated into the care process. The Innovative Medicines Initiative project,…
Roughly $4 trillion is spent on healthcare annually in the U.S. Despite this massive expenditure, roughly 80% of health outcomes are attributed to social, behavioral and environmental factors, known as social determinants of health (SDOH). What has been far less clear is how providers and payers can fully harness SDOH data to proactively manage 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 Biden administration is exploring making more payment models mandatory in the future as it implements a more patient-centric vision for value-based care. Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler detailed parts of this vision on Thursday during an interview with Health Affairs Editor-in-Chief Alan Weil. Fowler said voluntary models come with major…
The answer to solving a healthcare crisis that exacerbates barriers to care among some of the most vulnerable patient populations in the country is staring us in the face. For rural hospitals straining under the weight of erratic patient volumes, sicker populations and lack of funding, the path forward is in value-based care. But providers…
The Triple Aim. The Quadruple Aim. Right care at the right place at the right time. Whether one works in a hospital or small independent practice, healthcare providers are leaning on these concepts to deliver valuable care to their patients, and that is in its simplest form: care that results in the best patient outcomes…