Southwestern Health Resources (SWHR) is an integrated health care network formed in 2015 with the purpose of filling gaps in care. It’s also part of one of the top Next Generation Accountable Care Organizations (ACOs) in the nation. Having an unwavering commitment to lowering “total cost of care” has been a main factor in that…
Specialists are key partners for delivering value-based care, particularly for patients with chronic diseases. This involves the appropriate diagnosis of conditions, including rare diseases, stewardship of diagnostics and value-based prescribing for specialty medications. Lawrence Kosinski, M.D., MBA, founder and chief medical officer of SonarMD, a tech-enabled care coordination solution for digestive health, notes the great…
Amid a return to utilization of in-person health care, telehealth and issues highlighted by the pandemic, such as health equity, will continue to grow in influence within health and well-being strategies, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions. AJMC®: Hello, I’m Matthew Gavidia. Today on the…
Telemedicine use skyrocketed among primary care practices during the pandemic, specifically for those with a value-based payment model, according to a research letter published in JAMA Health Forum. Many patients were forced to delay primary care due to the pandemic, which resulted in significant revenue losses for primary care organizations. Telemedicine use naturally increased to make up for lost revenue…
Amid pervasive workforce shortages and a growing demand for services, Optum Behavioral Health is working to reimagine the way behavioral health care is delivered. CEO Katherine Hobbs Knutson, who joined the company about a year ago, is leading the charge. “That divide between … what exists in the field versus what people actually have access…
The transition from a fee-for-service healthcare model to value-based care (VBC) in the U.S. has continued to gain momentum in the wake of the Covid-19 pandemic. That’s because providers operating on a fee-for-service basis saw revenue fall sharply through much of last year as elective procedures were cancelled and many patients delayed primary care, even…
As the chief operating officer at a company that supports health systems and health plans in transitioning to value-based care, providers often ask me how they can best prepare their organization now for the slow-moving progression from fee-for-service to value-based care. When I am asked this question, I most often share the following anecdote: Value-based…
Value-based care has been on the horizon for years. Providers that were ready to leverage digital tools to deliver care remotely experienced success when the payment model finally took hold during the early days of the pandemic. “When we look at the pandemic and how hospitals performed financially, it’s those hospitals that had already started…
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…