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 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…
Health plans in the United States are increasingly shifting away from traditional fee-for-service (FFS) reimbursement toward value-based care (VBC) models, which incent the quality of care as opposed to quantity. Although the promise of high-quality, cost-effective care is alluring, the adoption of and engagement in these programs has proven challenging for both plans and providers…
High-quality primary care implementation requires significant healthcare payment reform, expanded telehealth capabilities, and team-based care, according to a recent report from the National Academies of Sciences, Engineering, and Medicine. According to the report, 85 deaths per day are associated with the declining workforce in primary care. Compensation in primary care is typically lower than that of specialty…
The move to value-based care—where payment for volume of services is being supplanted by payment for outcomes of care—has proceeded with remarkable speed since the Affordable Care Act (ACA) went into law a mere ten years ago. Payment for outcomes increasingly focuses on holding providers of healthcare responsible for total costs of care. Accountable Care…
The conversation about transitioning the American healthcare system from fee for service (FFS) to value-based care (aka, pay for performance) has been going on for more than 15 years. Still, it felt like time travel to come across a Health Affairs book review from 2006 by the late Princeton Professor Uwe Reinhardt that could have been written…
Some believe that an ACO’s leadership structure predicts its success. They point to differing savings results for physician-led versus hospital-led ACO shared savings models (MSSPs) to make their case. In particular, they make the argument that future Value-Based Care (VBC) policies should benefit the growth of successful physician-led ACOs, protecting them from policies that force…
Each year, a growing number of providers are entering value-based care arrangements, including primary care providers (PCPs). Given their holistic view of patients, PCPs are the best types of clinicians to drive value-based care. Medicare’s Primary Care Transformation programs and many payer-developed value-based care contracts are proof of the move for PCPs to be at…
As providers and payers invest in the move from volume to value, they are facing the reality that clinicians are lacking when it comes to training, education, and technology specific to enabling value-based care over fee-for-service. In order to succeed in this transition, practicing clinicians and emerging residents need hands-on support and investment to evolve,…
It has been clear for years that social determinants of health (SDOH) – factors such as education, economic and housing stability, community support, and access to transportation – have a disproportionate impact on health outcomes. Research shows that SDOH accounts for up to 80% of health outcomes, while medical care – which costs the U.S….