Public Health 4.0, or Population Health 4.0, is the recognition of health as a global entity and the focus on identifying and eliminating health disparities, unnecessary costs, and comorbidity. Unlike the previous three phases of public health, the focus in 4.0 is on population health management. As the healthcare industry moves toward a more holistic…
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 transition from traditional fee-for-service (FFS) payments to valuebased reimbursement models is fundamental to the future of healthcare. Rather than rely on the number of tests or procedures to inform financial reimbursement, value-based care (VBC) models incentivize providers to deliver on three components: improving the patient care experience, improving the health of populations, and reducing…
The healthcare industry in the U.S. has spent a whole generation talking about moving from a fee-for-service to a value-based model, focusing more on improved patient outcomes and early interventions rather than disease treatment. This shift has occurred gradually, sometimes purposefully, and sometimes in fits and starts, but overall, it has been slower than expected….
To say that hospitals and health systems have had to do more with less in the past 18 months is the understatement of a lifetime. These organizations have faced more than their fair share of unexpected challenges – from spiking patient demand, increasing costs and lost revenue, to overworked staff, a downturn in elective procedures…
During the past year, the pandemic strained the entire health care system. Many health care providers experienced significant disruptions with reductions in use and lower revenue. Some providers were able to weather the crisis by relying on the organizational competencies they had built for value-based payment models. Providers in more advanced payment models had more…
Value-based care (VBC) is a crucial step towards improving access, equity, and quality healthcare for Americans. Since the inception of Blue Cross Blue Shield in the 1930s, the US healthcare system has relied primarily on fee-for-service (FFS) payment practices. Essentially, you go to the doctor for a specific need, the doctor serves that specific need,…
The healthcare industry is in the throes of unprecedented change as hospitals, providers, and payors all grapple with new methods of delivering (and billing) medical care. The uptick of value-based care, coupled with the growing prevalence of alternative therapies, makes understanding this new model a must. So, what exactly is value-based care? And why is…