Value-based Care

Providers in APMs Had Head Start with Managing COVID-19 Surge

by Jacqueline LaPointe

Healthcare providers participating in alternative payment models leveraged their value-based care capabilities to safely manage the COVID-19 crisis, a new survey showed. For more coronavirus updates,...

ACO Participation Did Not Lower Care Access for Vulnerable Patients

by Jacqueline LaPointe

Physician groups did not reduce their share of vulnerable patients after joining an accountable care organization despite claims of the opposite, a new study from the Perelman School of Medicine...

Providers Say Cost Transparency Will Improve Value-Based Care

by Emily Sokol, MPH

As the healthcare industry continues to move towards value-based reimbursement, providers are calling for increased cost transparency to succeed in these models. Earlier work from Insights...

Home Hospital Reduces Costs, Readmission for Acutely Ill Patients

by Emily Sokol, MPH

Unnecessary hospitalizations are costly and are often predictors of even more expensive readmissions. So many value-based contracts push for creative solutions that keep patients out of the hospital...

Healthcare Reimbursement Still Largely Fee-for-Service Driven

by Emily Sokol, MPH

Value-based reimbursement is frequently cited as healthcare’s silver bullet. Changing the way providers are incentivized to deliver care can alter care delivery, placing the focus on...

CMS Relaxes Quality Reporting for Value-Based Purchasing Models

by Jacqueline LaPointe

Providers participating in some of Medicare’s largest value-based purchasing models will have some flexibility with quality reporting due to the ongoing COVID-19 pandemic, CMS announced last...

High-Cost Utilization Persists Despite PCMH Implementation

by Jacqueline LaPointe

A study of the Veterans Health Administration’s patient-centered medical home (PCMH) implementation found no association between progress with the alternative care delivery model and high-cost...

ACOs Back Hospitalization Alerts in Final Interoperability Rule

by Jacqueline LaPointe

Accountable care organizations (ACOs) are calling a new Medicare requirement on hospitalization alerts “a win for better population health management,” the National Association of ACOs...

Paving the Path to Success: Teaching Doctors Value-Based Care

by Jacqueline LaPointe

The way physicians have historically provided care – and gotten paid for it – is not working for most industry stakeholders. Smartphones, telehealth, and other innovative technologies are...

85% of Health Facilities Use Locum Tenens To Fill Care Gaps

by Samantha McGrail

Eighty-five percent of healthcare workforce management reported using locum tenens physicians sometime during the last 12 months, down from 94 percent in 2016, according to a recent...

Inpatient No Longer King as Hospital Outpatient Revenue Grows

by Jacqueline LaPointe

“Heads in beds” is no longer the motto for hospitals, which are seeing their hospital outpatient revenue nearly equal inpatient revenue, according to a new report from the Deloitte Center...

2019 Single Worst Year for Rural Hospital Closures, Report Finds

by Samantha McGrail

On top of 19 rural hospital closures, more than 450 rural hospitals are vulnerable to closure as the stability of the rural health safety-net continues to plummet, according to a recent report...

Claims Reimbursement Changes Notably Reduce Low-Value Care

by Samantha McGrail

A greater reduction in low-value vitamin D screening was associated with a claims reimbursement change related to recommendations, according to a recent study. Published in JAMA Network Open on...

Out-of-Network Primary Care Linked to Higher ACO Costs

by Emily Sokol, MPH

Patients receiving primary care outside of their defined accountable care organization (ACO) network drive up costs for ACOs, a recent study from Portland State University said. The Medicare Shared...

Policymakers, Industry Leaders Call for Innovation Center Changes

by Jacqueline LaPointe

The CMS Innovation Center – otherwise known as CMMI – has been the federal government’s key instrument for healthcare payment and care delivery reform. But lately, policymakers and...

Providers Lagging with Value-Based Care, Consumer Strategy

by Jacqueline LaPointe

When it comes to adopting value-based care and developing a consumer strategy, providers are significantly further behind compared to payers, according to the tenth annual Industry Pulse Report from...

Advanced Primary Care Promotes Value-Based Care

by Emily Sokol, MPH

Primary care is at the heart of the care delivery system. Over three-quarters of the general population only require primary care services in a given year. Yet primary care rates have been declining...

Physicians Propose 5 Quality Measures to Improve Medical Billing

by Samantha McGrail

Medical billing quality is a type of medical quality and should be tracked the same way healthcare organizations track medical complication rates and other quality indicators, two physicians from Johns...

Commercial Payer Spent $5.5B on Low-Value Care Services

by Samantha McGrail

Nearly $5.5 billion was spent on 20 low-value care services in 2015, according to an analysis of health care claims from the Research Consortium for Health Care Value Assessment. The analysis, funded...

AMGA: Advancing Value-Based Care Hinges on Claims Data Access

by Jacqueline LaPointe

AMGA (American Medical Group Association) recently sent a letter to Congress outlining what it views as 2020’s top priorities for medical groups and health systems. Chief among the group’s...