There’s a strong possibility that Medicare will move to mandate value-based payment models (VBP) for the nursing home industry in the years to come, according to industry executives. Dr. René Lerer and Brian Cloch, CEOs for Longevity Health Plan and Transitional Care Management, respectively, spoke at a panel on the future of VBP models during…
Decades in the making, the transition to value-based care may soon be complete. In June, Liz Fowler, the new deputy administrator of the Centers for Medicare & Medicaid Services (CMS) and director of its Center for Medicare & Medicaid Innovation (CMMI), suggested that CMS may soon require providers to be reimbursed based on patient outcomes. This…
Healthcare interoperability issues have always been confusing, changing, and difficult to address. The reason why is not straightforward: we have a fragmented health system with a myriad of specialized applications that are not universally used. Instead, we have a system where each organization elects which technology tools to use and in what configuration. Compounding this…
To date, 48 states plus the District of Columbia have implemented value-based care initiatives in one form or another. Driven by both efficiency and outcome, value-based care (VBC) models rely heavily on healthcare data from payors, providers, and patients in order to optimize performance. As more healthcare systems accept VBC models as the way of…
As Congress starts drafting a massive $3.5 trillion infrastructure package, a collection of provider groups is making a case for value-based care legislation to be included. Twelve hospital and physician groups wrote a letter to key House and Senate committee leaders Tuesday asking for the Value in Health Care Act to be included in the package. The…
The transition from treating patients at a provider’s site to delivering care in the home and community requires two things: an ability to incorporate social determinants of health (SDOH) into the care coordination process and the inclusion of value-based care (VBC) and community-based organizations (CBOs) as compensated care delivery partners in VBC networks. For health…
Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure noted higher participation in value-based payment models like Institutional Special Needs Plans (I-SNPs) during a recent discussion with HealthAffairs, but also hinted that consolidation of such programs may be needed. “Too many models in too many places that aren’t coordinated with each other,” is how Brooks-LaSure…
The Certified Community Behavioral Health Clinic (CCBHC) model has been shown to reduce hospitalizations, cut costs and improve employee recruitment and retention for participants. And on top of all that, it can also help set providers up for success in value-based care models. “CCBHC funds can really help organizations put those building blocks into place…
ACOs have zealously protected their favored status under Medicare Value-Based payment models, ensuring enough time for organizations to feel comfortable with financial risk and make investments in infrastructure. But if your own ACO is losing physicians to new equity-financed networks or to hospitals consolidating practices, more time does not help you. Primary care physicians are…
It was recently calculated the United States spends $3.8 trillion – or 18 percent of the national economy – on healthcare. The current healthcare landscape indicates this spending rate will not slow anytime soon due to the COVID-19 pandemic, an ongoing healthcare crisis. Value-based care models like Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs) have…