Many of the top health system and provider groups lauded the Department of Health and Human Services’ (HHS’) proposed regulations aimed at updating the decades-old Stark Law saying they believe it is the start to removing major regulatory headaches stymying the shift to value-based care models. The Centers for Medicare & Medicaid Services (CMS) and…
Value-BASED payment models require physicians to deliver the best outcomes while managing resources appropriately. Physicians have long focused on quality of care, but in a relatively new development, they now have to pay attention to resource utilization as well, with the goal of reducing overall cost of care. To succeed at this, they need data…
The past year saw multiple developments that could affect payment reform—a new administration was getting up to speed, the Affordable Care Act (ACA) was debated and its implementation modified through legislative and regulatory changes, and questions were raised about the future of alternative payment models. Despite this, implementation of the Medicare Access and CHIP Reauthorization…
Value-based care (VBC) has become a key component in our efforts to improve healthcare and reduce costs. Yet, various stakeholders regard VBC differently: If I asked 10 people to define VBC for me, I’m sure I’d get 10 different responses. The absence of agreed-upon VBC goals by all contributes to the “what’s in it for…
Orlando-based Florida Hospital President and CEO Daryl Tol said during a recent talk that the hospital has created a secret team called Project Fulcrum to “kill the old healthcare model,” according to the Orlando Sentinel. Here are three things to know: 1. Mr. Tol, who also serves as president and CEO of the central Florida…
While we served in different administrations, we faced similar challenges in trying to improve the nation’s health-care system. The basic goal was to improve the quality of the care delivered and moderate the costs. While there are several key reforms that will help us address this challenge, one idea that nearly all health leaders in…
When insurance plans charge patients less for the medicines that help them most, patients are more likely to take them, according to a new article. Taking a medicine every day in the hopes that it will prevent some long-range potential health catastrophe—like a heart attack or kidney failure—isn’t easy. Many people skip doses, or don’t…
Value-based care has resulted in medical cost savings, investments from commercial lines of business and an accelerated decline in fee-for-service, according to a Change Healthcare national research study. The study, conducted by ORC International in April and commissioned by Change Healthcare, included a survey of 120 managed Medicare, managed Medicaid and commercially focused payers. Here…
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…
The United States healthcare system is experiencing a major shift in delivery and payment policy to address out-of-control spending and low-quality care. In 2010, the Affordable Care Act (ACA) set in motion a new vision for healthcare delivery and reimbursement—value-based care—aimed at replacing the “broken” traditional fee-for-service (FFS) model. Massive change takes time, yet lawmakers…