Institutional special needs plans (I-SNPs) are seen by some to be the only path forward for skilled nursing facilities (SNFs) to enter value-based care, however, Brian Fuller, CEO of care coordination company Integrated Care Solutions (ICS), thinks SNFs should get more involved with direct contracting entities (DCEs). A lack of understanding may be preventing them…
The US health care system is increasingly moving towards value-based care to promote improved health outcomes for Americans. This can be seen across Medicare Advantage Plans (MA Plans), Accountable Care Organizations (ACOs), and Certified Community Behavioral Health Centers (CCBHC), among others. This movement also demands a transformation of reimbursement models to value-based contracting, with a…
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…