Value-Based Contracting

CMS Stops Accepting New Direct Contracting Applications

by Jacqueline LaPointe

CMS has announced that it will not be soliciting any more applications for the Global and Professional Direct Contracting Models slated to launch on January 1, 2022. Organizations that had already...

Preparing Physician Practices for Direct Contracting, Risk Models

by Jacqueline LaPointe

Physicians want three things, according to Anthony Valdés, President of Collaborative Health Systems, and those are to deliver great clinical outcomes, get paid fairly for that...

A New Administration, Value-Based Payment to Dictate 2021 Success

by Jacqueline LaPointe

2021 may not have started as the fresh page everyone was hoping for, but a new administration could be making some well-worn strategies more relevant. In a new Healthcare Strategies podcast, the...

Fee-For-Service Payments Still an Issue in VT All-Payer ACO Model

by Jacqueline LaPointe

Reimbursing accountable care organizations (ACOs) for value in a primarily fee-for-service payment environment is creating implementation challenges for Vermont’s innovative All-Payer ACO Model,...

ACOs Fear Direct Contracting Options Stray Too Far From Providers

by Jacqueline LaPointe

Value-based providers, like accountable care organizations (ACOs), may be at a disadvantage under new direct contracting options in Medicare that allow for a broad range of healthcare organizations to...

Making Data Sharing A Condition in Value-Based Contracts

by Jacqueline LaPointe

Healthcare data sharing is central to a successful value-based care strategy, according to Jamie Reedy, MD, MPH, chief of population health for Summit CityMD. “If the physicians and care...

CMS Announces A New Value-Based Direct Contracting Model

by Jacqueline LaPointe

A new direct contracting model from CMS will test whether a geographic-based approach to value-based care can improve quality of care while reducing costs for Medicaid beneficiaries in a specific...

Payers, Providers Need Data to Talk Value-Based Care

by Jacqueline LaPointe

The definition of value is evolving, and so are the capabilities needed to support the transition to value-based care, industry experts recently shared at Xtelligent Healthcare Media’s...

HHS Overhauls Key Healthcare Fraud Laws to Advance Value-Based Care

by Jacqueline LaPointe

After years of debate, HHS agencies have made changes to two major healthcare fraud, waste, and abuse laws that providers have said get in the way of value-based care progress. Late last week, CMS and...

Key Considerations for Providers Thinking of Capitation Payments

by Jacqueline LaPointe

More providers are thinking of switching to capitation payments in light of the COVID-19 pandemic. However, the decision should not be taken lightly; provider organizations need to consider the major...

51 Organizations Join New Direct Contracting Opportunity from CMS

by Jacqueline LaPointe

CMS recently announced that 51 organizations will take part in a new directing contracting opportunity that will test what the agency calls the “next evolution of risk-sharing...

Designing Alternative Payment Models for Health System Resiliency

by Jacqueline LaPointe

Alternative payment models that use population-based payments to incent providers to deliver coordinated, high quality, person-centered care are key to building healthcare system resiliency after a...

A Unique IPA Centers on Social Determinants of Health

by Jacqueline LaPointe

More and more healthcare providers and payers are teaming up with ride-sharing companies, food pantries, and other community-based organizations to address one of the largest drivers of patient...

How Top Accountable Care Organizations Save Year After Year

by Jacqueline LaPointe

Accountable care organizations had a record year, according to the latest performance data for the Medicare Shared Savings Program. CMS recently announced that organizations participating in the program – which are otherwise known...

Healthcare Providers Did Not Take On More Financial Risk in 2019

by Jacqueline LaPointe

Nearly half of healthcare executives said 10 percent or less of their organization’s revenue came from risk-based contracts in 2019 despite expectations that financial risk in healthcare would be...

PCPs Paid Under Global Capitation Deliver Higher Quality Care

by Jacqueline LaPointe

Global capitation payments provide strong incentives for primary care physicians to achieve key quality metrics, including cancer screening and medication review, UnitedHealth Group concluded from new...

CMS Unveils New Value-Based Care, ACO Options for Rural Providers

by Jacqueline LaPointe

A new rural health model recently unveiled by CMS will offer rural providers and their communities new funding opportunities to bolster value-based care through capitated payments and accountable care...

Some Alternative Payment Models Are Improving Behavioral Health

by Jacqueline LaPointe

Alternative payment models (APMs) are taking steps to improve behavioral health, but the models need more to make large strides, according to a study from the University of Washington and Harvard...

Value-Based Incentives Didn’t Reduce Hospital-Acquired Infections

by Jacqueline LaPointe

Two of Medicare’s value-based incentive programs did not improve the levels or trends of certain hospital-acquired infections, potentially widening the gap between safety-net and non-safety-net...