Risk Assessment

How Healthcare Organizations Can Help Improve Social Risk Interventions

February 6, 2023 - Financing healthcare organizations’ involvement in social risk interventions would require multiple funding approaches and is not guaranteed to improve the delivery of social services, according to research published in JAMA Health Forum. Social determinants of health, such as food insecurity, housing instability, and poor transportation...


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Value-Based Care Assessment: The First Step to Value-Based Care

by Emily Sokol, MPH

Starting the transition from fee-for-service to value-based care is a challenge. Many provider organizations are simultaneously juggling new reimbursement models with old ones and breaking...

Medicare Payments Unfair to Providers Treating Vulnerable Patients

by Emily Sokol, MPH

Medicare’s reimbursement methodology risks unfairly paying providers, hospitals, and Medicare Advantage plans who treat vulnerable populations. In value-based payment models, Medicare uses risk...

Medical Groups Worry About Risk in Anti-Kickback, Stark Law Reform

by Samantha McGrail

Tying Anti-Kickback and Stark Law reform to the level of financial risk providers assume creates more complexity and burden and could impede the transition to value-based care for physicians, advocacy...

NQF Eyes Adding Social Risk Factors to Value-Based Purchasing

by Jacqueline LaPointe

In response to stakeholder concerns that value-based purchasing programs unfairly penalize providers who treat greater proportions of disadvantaged patients, the National Quality Forum (NQF) recently...

AMGA: Slow Encounter Data Transition in Medicare Reimbursement

by Jacqueline LaPointe

The American Medical Group Association (AMGA) recently commended CMS for decelerating the transition to using encounter data as a means for risk-adjusting Medicare reimbursement to Medicare Advantage...