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…
The proportion of value-based payments from the commercial sector to physicians and hospitals increased from 10.9 percent in 2012 to 53.0 percent in 2017. However, an overwhelming majority of those alternative payments were built on a fee-for-service foundation. Those were the findings captured in the latest National Scorecard on Payment Reform, released in December 2019 by…
Payers that implemented value-based payment models reduced healthcare costs by an average of 5.6 percent, improved provider collaboration, and created more impactful member engagement, according to a new study from Change Healthcare. The Finding the Value: The State of Value-Based Care in 2018 report, presented at the 2018 AHIP Expo, found that payers are effectively…
Creating strong networks of high-quality healthcare providers can be a major challenge for any payer looking to expand its value-based care contract portfolio. Providers aren’t the only ones accepting risk when entering into pay-for-performance arrangements since payers are also putting revenue and reputation on the line. In order to ensure that a contracting arrangement can…
UnityPoint Health’s participation in the initial rollout of CMS’ Next Generation ACO Model helped them succeed beyond their expectations in their transition to reimbursement risk. In performance year 1 (2016), UnityPoint’s 85,000-member Iowa Health ACO earned more than $10.5 million in shared savings. Like most health systems, UnityPoint still gets more revenue from fee-for-service than…
The inaugural MIPS 2017 submission period closed in a fog of uncertainty. The demise of MIPS looms on the horizon, with little discussion of opportunities for improvement. Heath and Human Services Secretary Azar has advocated for removing the quality reporting component of MIPS, while the Medicare Payment Advisory Committee (MedPAC) recommended scrapping MIPS altogether and pushed…
Accountable care may still be a relatively new model in some areas, but the numbers of ACOs are steadily increasing. There were approximately 660 ACOs in the U.S. in 2015. The number increased to 838 last year. Success, however, can be elusive. Only about one-fourth of U.S. hospitals entered into value-based contracts have been able…