Value-Based Contracting

More Provider Orgs Have Value-Based Contracts With Private Payers

November 8, 2023 - More provider organizations are participating in value-based contracts outside Medicare, as three-quarters of respondents were under contracts with commercial and Medicare Advantage plans in 2022, a study published in the American Journal of Managed Care found. The study is based on results from a web-based survey of 100 provider organizations...

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Value-Based Reimbursement Grows as Providers Take on More Risk

by Jacqueline LaPointe

Over half of healthcare payments last year were made through value-based reimbursement models, with most of those payments tied to some degree of financial risk, according to the latest data from the Health Care Payment & Learning...

Unlocking the Future of Value-Based Care With Data

by Jacqueline LaPointe

Advocate Health is a value-based care leader. More than 2.4 million lives are covered by the health system’s value-based care contracts, which include 12 different accountable care organizations (ACOs) and clinically integrated...

New ACOs Push CMS Closer to Accountable Care Goals

by Jacqueline LaPointe

CMS has announced that more than 700,000 healthcare providers and organizations are participating in one of three accountable care organization (ACO) models, including the Medicare Shared Savings...

Lawmakers Ask CMS to Inspect ACO REACH Model to Prevent Fraud, Abuse

by Victoria Bailey

A group of lawmakers, spearheaded by US Senator Elizabeth Warren (D-Mass.) and Representative Pramila Jayapal (D-Wash.), has asked CMS to examine the ACO REACH model to prevent organizations with a...

APG Direct Contracting Entities Helped Save Medicare $70M in 2021

by Victoria Bailey

The Global and Professional Direct Contracting Model generated $70 million in net savings for the Medicare program in 2021, with several member organizations of America’s Physician Groups (APG)...

KLAS: Epic, Arcadia, Innovaccer Earn Top Marks for Value-Based Care

by Jacqueline LaPointe

According to a new report from KLAS, payers and providers are looking to expand their value-based care contracts across business lines, and most are looking to do so with a fewer number of strategic...

Key Plans for Advancing Accountable Care, Value-Based Payment

by Jacqueline LaPointe

Accountable care is getting a makeover. For over a decade, the healthcare system has been making the shift to accountable care, or “the coordinated provision of patient services by healthcare providers and facilities with the goals...

Value-Based Payment, Fee-for-Service Levels Hold Steady

by Jacqueline LaPointe

Value-based payment levels barely moved in 2021, with some movement in the downside financial risk category, according to the latest data from the Health Care Payment Learning and Action Network (HCP LAN). The majority of healthcare...

Who is Leading the Value-Based Care Transition in Primary Care?

by Jacqueline LaPointe

Most primary care physicians (PCPs) are engaging with value-based care, with 69 percent participating in some type of alternative payment model. But a new report from Chartis Group has identified the...

Staff, Technology Investments Help Practices Shift to Value-Based Care

by Victoria Bailey

Staffing and technology are the top investment areas for primary care practice leaders as they manage the challenges of shifting from fee-for-service (FFS) models to value-based care, according to a...

4 Key Areas of Value-Based Care Transformation

by Jacqueline LaPointe

Healthcare has a spending problem. For all the investments made in healthcare—$4.1 trillion to be exact—outcomes are not where they should be. In fact, the US has the lowest life expectancy compared to other high-income...

MGMA Calls for Prior Authorization Reform in Medicare Advantage

by Victoria Bailey

The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA...

Value-Based Payment Makes Up Just 6.7% of Primary Care Revenue

by Jacqueline LaPointe

The transition to value-based payment is moving at a snail’s pace despite healthcare’s long journey with the transition away from fee-for-service, new survey data indicates. Value-based...

Will Medicare Physician Fee Schedule Changes Drive Value-Based Care?

by Victoria Bailey

The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits...

Risk-Based Alternative Payment Models Aid Chronic Disease Management

by Jacqueline LaPointe

Alternative payment models that put financial risk on healthcare providers improved care quality for patients with diabetes more so than fee-for-service and incentive payment programs, according to a...

Opportunities, Challenges of Value-Based Care Adoption

by Jacqueline LaPointe

Kenneth L. Davis, MD, believes that keeping patients healthy and ultimately out of the hospital is the key to making healthcare more affordable. That is why he is leading one of the nation’s top health systems down the path of...

Home Healthcare Providers Share Thoughts on Value-Based Care

by Victoria Bailey

Although some home-based care professionals are still unsure about the impact value-based care has had on their organizations, over four in 10 home healthcare providers expect value-based contracts to...

Organizations Urge CMS, HHS to Terminate New ACO REACH Model

by Victoria Bailey

More than 200 healthcare organizations, including Physicians for a National Health Program (PNHP) and the American Medical Student Association, have urged CMS and HHS to terminate the ACO REACH model,...

NAACOS Launches Coalition for ACO REACH Model Participants

by Victoria Bailey

The National Association of ACOs (NAACOS) has launched a coalition to help providers learn about and prepare for the new ACO Realizing Equity, Access, and Community Health (REACH) model. The coalition...

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