Value-based Care

Breaking Down Common CMS Value-Based Payment Programs

by Victoria Bailey

Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from...

CMS Plans to Reweight 2021 MIPS Cost Performance Category

by Victoria Bailey

CMS will reweight the cost performance category under the Merit-Based Incentive Payment System (MIPS) for the 2021 performance period due to the COVID-19 pandemic’s impact on clinicians and cost...

Healthcare Merger Aims to Advance Value-Based Kidney Care

by Victoria Bailey

Three healthcare providers—Fresenius Health Partners, the value-based care division of Fresenius Medical Care North America, InterWell Health, and Cricket Health—have entered into a...

What Is Value-Based Care, What It Means for Providers?

by Editorial Staff

Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and...

Signify Health to Acquire Caravan Health, Further Value-Based Care

by Victoria Bailey

Value-based care platform Signify Health has signed an agreement to acquire Caravan Health and aims to increase participation in value-based payment models and improve patient outcomes. The merger...

What Is Healthcare Revenue Cycle Management?

by Editorial Staff

While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is...

NAACOS, AMA Urge Congress to Boost Value-Based Care, APM Incentives

by Victoria Bailey

A group of eight healthcare organizations, including the American Medical Association (AMA) and National Association of ACOs (NAACOS), have asked Congress to increase their efforts in promoting...

Investor-Owned Health Systems Linked to Most Low-Value Care

by Sarai Rodriguez

Overuse of low-value services was most often seen in healthcare systems that had more beds, had fewer primary care physicians, had more physician practice groups, and were...

Over 50 Lawmakers Urge Administration to End Direct Contracting

by Sarai Rodriguez

More than 50 lawmakers led by US Representative Pramila Jayapa urged the Biden administration to discontinue the Medicare Direct Contracting (DC) program and transition Medicare...

Patient-Driven Payment Linked to a Decrease in SNF Therapy Utilization

by Sarai Rodriguez

The implementation of the Patient-Driven Payment Model (PDPM) was associated with a decrease in the volume of rehabilitation therapy utilization, according to a study published in JAMA...

Study Finds Low-Value Services Increases Risk for Direct Harm

by Sarai Rodriguez

A study analyzing Choosing Wisely recommendations found that nearly 50 percent of identified low-value services may cause direct potential harm. Published in JAMA Network, researchers...

CMS Axes Primary Care First Model’s Seriously Ill Population Component

by Jacqueline LaPointe

CMS has notified providers via email that it will not move forward with the Seriously Ill Population (SIP) Component of the Primary Care First Model. The Model started in 2021 but the Biden...

How Providence Is Overcoming a Top Value-Based Care Challenge

by Jacqueline LaPointe

Providence St. Joseph Health has been at the forefront of delivering high-quality, affordable care to patients. Value-based care is a vital pillar of the health system’s strategic plan for transforming care to improve outcomes and...

Study: Consecutive Penalties for Preventable Hospital Readmissions

by Victoria Bailey

More than 1,200 hospitals have faced penalties for preventable hospital readmissions every year for the last 10 years since the launch of the Hospital Readmissions Reduction Program (HRRP), according...

62% of Consumers Unfamiliar with Value-Based Care, Study Finds

by Victoria Bailey

More than half of consumers are unfamiliar with value-based care, and for the ones who are aware of it, only a quarter can define the healthcare model correctly, a new study from nonprofit health plan...

CMS Lays Out New Strategy for Advancing Value-Based Care, APMs

by Jacqueline LaPointe

The delivery and payment of care will look a lot different by 2030, according to CMS. The federal agency has announced that it expects all Medicare beneficiaries with Parts A and B to be in a care...

Value-Based Payment Models May Help Hospitals Prepare for Surges

by Victoria Bailey

Hospitals and health systems can implement value-based payment models to ensure preparedness for seasonal and pandemic capacity surges, according to industry experts. Hospitals experienced increased...

Surgical Costs, Complications Slowed Under MD’s All-Payer Model

by Jacqueline LaPointe

An all-payer model that puts caps on hospital spending has slowed surgical spending and the rate of avoidable complications across major surgical procedures, according to a recent study published in...

Lessons Learned from Aetna, Cleveland Clinic’s Joint ACO Model

by Jacqueline LaPointe

In August 2020, Aetna and Cleveland Clinic announced an innovative product for employers in Northeast Ohio. The two leading healthcare organizations partnered to form an accountable care organization...

How Morgan Health is Paving the Way for Advanced Primary Care

by Jacqueline LaPointe

Advanced primary care tied to a person-level payment model is key to improving outcomes and reducing costs, at least according to the Duke Margolis Center for Health Policy and Morgan Health, a new...