As the nation’s largest health care payer, responsible for more than one in five dollars spent on health care within the United States, Medicare plays a key role in transitioning the health care system away from fee-for-service, which incentivizes quantity of care, and towards value-based care, which incentivizes high-quality care and smarter spending. The passage…
Download Slides For many value-based care providers, one of the biggest obstacles is often the 10% to 20% of your population who make up your most “challenging” chronic patients. Treating and managing those chronic conditions is no mystery. The problem is getting your unengaged patients to better understand and take control of their…
Download Slides When communication between various providers and sites of care is broken or nonexistent, gaps in care can lead to many patients falling through the cracks. As the healthcare industry shifts toward value-based care models, hospitals need to ensure successful patient transitions and recovery, provide high-quality care, drive revenue, and mitigate risk. Join…
After years spent transforming your health care technology, you may feel like you’re almost done. But Value-Based Care Technology requires a different mindset. With reimbursement scaling to a tipping point for APM adoption, think “reboot” instead. Your health system or group has a long way to go if your aggregated and integrated data cannot support…
Hospitals are increasingly turning to value-based care initiatives to transform care delivery, lower the total cost of care, and improve patient outcomes. Unlike traditional fee-for-service (FFS) models that reimburse providers based on volume (i.e., the number of patient visits), providers are reimbursed based on the quality of care delivered in value-based care. Ultimately, success under…
Incentivized by the Centers for Medicare & Medicaid Services (CMS) to transform care delivery to improve outcomes, healthcare stakeholders are increasingly turning to value-based care initiatives. Outcomes are now contingent on providers working together across the continuum for shared goals, but hospitals are often not equipped with the resources necessary to do so. That’s where…
Interoperability in healthcare, it would seem, is at an important inflection point. Rules around data exchange have been around for years, and regulate what patient information gets shared between payers, providers and the patients themselves. There are also standards around how that information is shared, and the forms it can take. But the transition to…
Championed by government entities like the Centers for Medicare and Medicaid Services and the Department of Health & Human Services, value-based care is here to stay. Hospitals are increasingly participating in value-based programs—such as the Hospital Readmissions Reduction Program and Bundled Payments for Care Improvement—in an effort to improve care delivery and patient outcomes while…
The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus the…
The Center for Medicare and Medicaid Innovations (CMMI) recently announced the ACO Realizing Equity, Access, and Community Health (REACH) Model. The REACH Model will replace the Direct Contracting model starting on 1/1/23. ACO REACH retains the DC Model Global and Professional tracks and adds new requirements to advance equity, promote provider governance, and protect beneficiaries….