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News & Studies

February 19, 2021

A 2021 AcademyHealth National Health Policy Conference panel focused on current Medicaid challenges and looked ahead to the future of the 50 year-old program proposing potential reforms.
 

February 17, 2021

Richard Queen, Director of Data Solutions at Memorial Health in Ohio, explains how they are using technology to drive value-based care.

February 17, 2021

Medicare spending increased on opioids and antibiotics, however low-value care spending has marginally decreased as value-based care is slowly adopted.

February 16, 2021

As value-based care becomes more popular, capitation reimbursement models could help ensure care delivery is based on quality, not quantity..
 

February 15, 2021

Caring for seniors means attending to both their physical and emotional health. Unfortunately, the mental health of older patients is rarely evaluated and treated.

February 10, 2021

Engaging and listening to physician leadership early and often can make the VBC transition smoother and less complex over time for both providers and payers

February 8, 2021

To improve their care management strategies, payers can better identify sources of value, target the right kind of healthcare spending, bolster consumerism, and use operational metrics.
 

February 4, 2021

Blue Cross NC has launched a value-based care model set to improve health outcomes and member experience using patient-centered kidney care.

February 4, 2021

The Centers for Medicare & Medicaid Services has sent a clear message to states and providers: they already have the tools to improve healthcare. 

January 30, 2021

The company’s entrance into the state’s Medicaid program supports its continuing commitment to improving the health of its communities and building stronger provider partnerships
 

January 29, 2021

As tech and data sharing become more pervasive, healthcare will likely pivot to being more predictive, and telehealth will evolve, giving rise to new modalities of care.

January 27, 2021

The Washington-based organization is taking aim at the shift from fee-for-service to value-based care and looking for ways to ensure that connected health concepts and tools are included in the conversation.

 

January 25, 2021

The American Academy of Orthopaedic Surgeons released a value-based care continuum to help orthopedic surgeons better understand various alternative payment models.
 

January 22, 2021

Revenue cycle and finance professionals are up against a lot of uncertainty as a new administration takes over, but value-based payment could be the intersection of provider and policy.

January 18, 2021

For almost the past four years, the Centers for Medicare & Medicaid Services has sought to advance value-based care across all programs and initiatives. 

January 14, 2021

The Center for Medicare and Medicaid Innovation has released an overview of its value-based care models and lessons learned including introducing new models and refining older ones.
 

January 12, 2021

In somewhat of a surprise move, U.S. health care policymakers unveiled plans last week to expand the Home Health Value-Based Purchasing Model, a nine-state Medicare demonstration designed to better align reimbursement to quality of care.

January 11, 2021

According to a recent survey from BDO, the majority of health care financial leaders view home care as a key area of investment.  The survey includes the responses of 100 CFOs at U.S. health care organizations.

January 10, 2021

The next chapter of value-based care should measure engagement like our lives depend on it. We should unleash the power and convenience of digital tools to move the needle on value-based care.
 

January 8, 2021

The U.S. Department of Health and Human Services announced Friday that it is expanding the Home Health Value-Based Purchasing Model. First implemented in 2016, the model is currently active in just nine states

January 6, 2021

Some value-based care veterans believe the emerging direct-contracting models are inherently flawed, particularly the most recently unveiled “geographic” option.

January 3, 2021

A recent report from Better Medicare Alliance and Avalere Health is now putting hard numbers on home health services and post-acute care.

December 31, 2020

Artificial intelligence supported payers’ strategies around industry goals such as value-based care, member engagement, and medication adherence.

December 31, 2020

In the finalized rule, CMS addressed two concerns that payers and other stakeholders had about the definition of value-based purchasing and implications for “best price” policies.

December 16, 2020

A Blue Cross and Blue Shield of North Carolina executive shares how the payer quickly shifted its membership toward value-based care agreements from 2019 through 2020.

December 10, 2020

“It’s important to us to provide support and resources for primary care groups that seek greater financial stability and wish to transition from fee-for-service to value-based care.”

December 9, 2020

Throughout the health care community, there is increasing recognition of the significant impact of social determinants of health (SDoH) on individual health and quality of life. Here are some of the most significant factors:

December 3, 2020

In the new Medicare value-based contracting model, participating organizations take on the full risk and receive payments based on outcomes.

December 3, 2020

The new regional model adds to a growing portfolio of direct contracting models, which test the “next evolution of risk-sharing arrangements,” according to CMS.

December 3, 2020

The contracts are complicated and full of risks for drug companies. But there’s also a risk to steering clear of the arrangements — reduced or restricted access to a company’s medication.

December 1, 2020

Home-based care company Prospero Health announced Tuesday it is expanding into
16 additional states to serve 8,000 new patients in 2021.

November 30, 2020

Georgia-based PatientBlox focuses on the value-based care space. Its blockchain technology platform is used to assist with the administrative side of healthcare, including data sharing and value-based payment models.

November 10, 2020

An analysis of the systems in Massachusetts, the Netherlands, Norway, and England reveals structural differences and variation in emphasis on programs used to effect value in care delivery.

November 25, 2020

The changes do not overhaul Medicaid managed care, but the alterations to network adequacy, beneficiary protection, quality measures, and payment deserve payers’ attention.

November 25, 2020

 Health care organizations with VBP models have had greater flexibility to effectively pivot their care delivery. We outline three strategies for payers and providers to embrace health equity in VBP design and implementation.

November 24, 2020

With more families staying apart, home-based care providers are gearing up to make seniors feel as comfortable and connected as possible. And most of them bring years of companionship experience to the table.

November 19, 2020

Pharmaceutical companies developing therapies and vaccines for COVID-19 face a unique challenge—not only creating and testing products amidst a public health crisis, but balancing shareholder expectations with public distaste for reaping large profits in the middle of a pandemic.

November 19, 2020

The Managed Care Cast looks at the adjustments made to delivering care to patients in order to keep patients, families, and clinicians safe.

November 17, 2020

According to the latest Home Health Chartbook individual and clinical characteristics of home health patients continue to shift, reflective of both America’s aging population and providers’ ability to handle more acute cases.

November 13, 2020

 Apixio’s artificial intelligence platform furthers Centene Corporations goal to bring innovation to healthcare and provide value-based care.

November 12, 2020

Overall, home health agencies created more than 2.22 million jobs in 2019, employing more than 1.51 million workers in the process. That workforce took home more than $49.52 billion in estimated total wages.

November 12, 2020

Industry experts share 5 challenges providers may encounter when switching from fee-for-service to capitation payments.

November 11, 2020

 The COVID-19 public health emergency has driven transformation in the provision of primary care services across the country.  Whether it’s the use of telehealth technology to facilitate “virtual visits” or the development of new treatment protocols.

November 10, 2020

First joint-venture between health system and health plan in the country set to enhance value-based care, streamline healthcare system experience.

November 9, 2020

In the midst of the in-home care M&A resurgence, Charter Healthcare Group has made a few moves of its own including its recent acquisitions of Heartwood Home Health & Hospice and Vitality Home Healthcare.

November 5, 2020

The organizations, which are largely medical groups and accountable care organizations, will participate in the implementation period of the Direct Contracting model between October 1, 2020, through March 31, 2021.

November 6, 20205

Payers have been tapping self-service screenings to address behavioral and mental healthcare, but that process has been anything but perfect.

November 3, 2020

Humana continues to shift its operations toward value-based care payment models, both with internal service lines and with external provider partnerships, and is also doubling down on social determinants of health at the same time.

November 2, 2020

An overwhelming majority of eligible clinicians participated in the Quality Payment Program despite facing challenges caused by the COVID-19 pandemic, according to preliminary data from CMS.

November 2, 2020

The two companies will establish a new accountable care organization that will work with community and rural hospitals to bring the benefits of value-based care to their communities.

November 2, 2020

Even during COVID-19, healthcare organizations need to prepare for value-based care reimbursement. The flight from volume to value is accelerating, and it represents a major opportunity for providers to grow their businesses.

October 29, 2020

In a new Healthcare Strategies podcast, Chris Waugh, chief innovation officer at Sutter Health, explains how the health system is creating a strategy that integrates virtual and in-person care to treat the whole patient.

October 28, 2020

The CAQH directory may support interoperability rule compliance by testing endpoints in advance and allowing payers and vendors to quickly access each others’ information.

October 27, 2020

PACE, a Medicare-Medicaid program serving thousands of seniors in 31 states, used telehealth to keep that care going during the pandemic. That success could spur more programs to use connected health in the future.

October 26, 2020

Despite mitigation efforts and progress on rapid testing, the U.S. is firmly in the middle of a third COVID-19 surge. Many believe another round of patient-volume disruption could be on its way if the situation isn’t contained.

October 26, 2020

Bills introduced in both the Senate and House call for Medicare coverage for home health care services provided via telehealth during a public health emergency. 

October 26, 2020

Value-based care models are becoming increasingly important for health systems. Implemented well, they can improve system economics, enhance care quality and outcomes, and strengthen physician alignment.

October 22, 2020

Encouraging the growth and expansion of value-based arrangements across all categories of government health care spending and providing states with maximum flexibility to design and operate their own Medicaid Programs.

October 21, 2020

Pharmacists in both health systems and community pharmacies have an important role to play in collaborating with health plans to communicate opportunities and succeed in value-based models. 

October 20, 2020

As Medicare Advantage (MA) enrollment explodes and plans begin to offer more benefits to members, home health and home care agencies alike need to prove their value in order to gain new business.

October 20, 2020

Several experts provide insight into what they are currently seeing in the final months of 2020. They also touch on 2021 expectations.

October 19, 2020

Home Care agencies are tracking key metrics like inquiry-to-admission rate, caregiver hiring ratios, caregiver turnover and revenue per non-caregiver employee to make sure they are one step ahead of new trends. 

October 14, 2020

The COVID-19 pandemic, the greatest challenge to public health in more than a century, provides us with a real opportunity to finally transform our health care system.  From virtual care, to the easing of regulations, the changes are coming. 

October 15, 2020

Although the ongoing public health emergency has increased the need for home-based care, the federal government has recognized the crucial part it plays in the health care system for years. That recognition is partly reflected by the evolution of Medicare Advantage.

October 14, 2020

The COVID-19 pandemic has been the burning platform for alternative payment models that use population-based payments for whole-person care, industry experts are saying.

October 14, 2020

 Value-based healthcare has steadily become the cornerstone reimbursement methodology to change provider behavior from transaction-based care to longitudinal, patient-centered care.  Improved health outcomes and lower out of pocket health expenditures are some of the many benefits. 

October 13, 2020

Stakeholders argue which form of accountable care organization is best for delivering value-based care insuring that patients are getting the best care for their money.

October 13, 2020

As U.S. health care costs continue to rise, CMMI’s work has grown increasingly important, especially around value-based care.  National health care spending is expected to grow at an average annual rate of 5.4% from 2019 to 2028.

October 12, 2020

Improving quality and reducing costs are the two pillars of value-based care, as both health care and political leaders increasingly recognize the unsustainable trajectory of the nation’s health care spend.

October 8, 2020

The coronavirus (COVID-19) pandemic has necessitated an unprecedented level of innovation and redesign. One prominent manifestation is the catalyst of telehealth from fringe to mainstream. 

October 7, 2020

There is no denying that COVID-19 threw an unexpected wrinkle into value-based care (VBC) contracts—but it might not be exactly the wrinkle we thought we’d see.

October 7, 2020

Released Wednesday, its most recent annual “Value-based Care Report” again reflected more positive outcomes for the 2.41 million Medicare Advantage (MA) beneficiaries receiving care from primary care physicians in VBP models.

October 6, 2020

The need for behavioral health services skyrocketed since the start of the COVID-19 pandemic. Payer-provider partnerships will be critical to maintaining these services throughout the pandemic and after.

October 1, 2020

Three major Medicare Advantage payers emphasized lower out-of-pocket costs for home healthcare telehealth benefits, premiums, and prescriptions.

October 1, 2020

The Ohio Department of Medicaid seeks to update its managed-care setup with a focus on wellness and improving the health of beneficiaries, meeting the needs of children with complex needs, and reducing administrative hurdles for patients and health-care providers.

September 30, 2020

Will COVID-19 accelerate or halt the move toward value-based payment? Christopher Chen, M.D., says doctors will embrace value over volume as layoffs and work reductions hit hospitals & medical practices that depend on FFS.

September 28, 2020

Payer and provider misalignment inhibits the success of value-based care, according to a recent report.

September 28, 2020

New research revealed private payers are more likely than their public counterparts to be participating in value-based reimbursement models.

September 23, 2020

The U.S. Centers for Medicare & Medicaid Services (CMS) took a new step on Wednesday to support care transitions from long-term care facilities into home- and community-based settings.

September 22, 2020

DHSS Division of Medicaid and Medical Assistance has authorized four health-care provider groups to serve as Medicaid Accountable Care Organizations (ACOs), important participants in the state’s effort to innovate around the quality and cost of health care, and to improve health outcomes for Delaware’s Medicaid population.

September 17, 2020

When examining health care quality and outcomes it is important to consider how differences in income and social risk across patient populations can affect providers’ quality ratings in value-based payment systems. These differences explain why risk adjustment for social needs helps advance quality and health equity.

September 23, 2020

The U.S. Centers for Medicare & Medicaid Services (CMS) took a new step on Wednesday to support care transitions from long-term care facilities into home- and community-based settings.

September 22, 2020

DHSS Division of Medicaid and Medical Assistance has authorized four health-care provider groups to serve as Medicaid Accountable Care Organizations (ACOs), important participants in the state’s effort to innovate around the quality and cost of health care, and to improve health outcomes for Delaware’s Medicaid population.

September 17, 2020

When examining health care quality and outcomes it is important to consider how differences in income and social risk across patient populations can affect providers’ quality ratings in value-based payment systems. These differences explain why risk adjustment for social needs helps advance quality and health equity.

September 17, 2020

CMS issued revised guidance providing detailed recommendations on ways nursing homes can safely facilitate visitation during the coronavirus disease 2019 (COVID-19) pandemic.

September 15, 2020

Medicare Shared Savings Program accountable care organizations spent less on surgical care by reducing inpatient surgery, increasing outpatient surgery, and reducing spending on postacute care after inpatient surgery.

September 15, 2020

CMS has decided to withdraw the controversial rule that would have led to significant cuts in Medicaid funding.

September 15, 2020

The CMS is releasing guidance for states on how to advance value-based care (VBC) across their healthcare systems, with a particular emphasis on Medicaid populations, and to share pathways for adoption of such approaches.

September 15, 2020

The CMS issued guidance to state Medicaid directors designed to advance the adoption of value-based care strategies across their healthcare systems and align provider incentives across payers.

September 11, 2020

Telehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting.

September 11, 2020

Four experts in value-based care share how a major disruption to the healthcare industry, like the COVID-19 pandemic, could be used to advance payer value-based care progress.

September 8, 2020

The COVID-19 public health crisis will push the industry further away from fee-for-service reimbursement and is currently impacting conversations about value-based contracts, according a recent report from Insights by Xtelligent Healthcare Media.

September 6, 2020

The financial challenges faced by healthcare providers during the COVID-19 pandemic highlight the revenue risk exposure imposed by the traditional fee-for-service (FFS) payment model and the benefits of participating in value-based payment models.

September 3, 2020

The federal government on Thursday confirmed the value-based structure of the remaining $2 billion in federal aid to nursing homes, with facilities that beat baseline COVID-19 infection and mortality rates set to receive more relief.

September 3, 2020

Value-based health care emerged more than two decades ago to improve quality while containing costs. However, its impact on racial health disparities has been limited.

September 2, 2020

Individuals enrolled in low-spending plans generated less healthcare spending, used high-value drugs and services less and were less satisfied.

August 27, 2020

The D.C. Council is scrutinizing a move by the Bowser administration that would reshuffle health coverage for hundreds of thousands of the District’s sickest and poorest residents.

August 26, 2020

Beginning January 2021, the U.S. Centers for Medicare & Medicaid Services (CMS) will add a hospice component to the Medicare Advantage Value-Based Insurance Design (VBID) Model, commonly called the Medicare Advantage hospice carve-in.

August 25, 2020

School plans, large parties, and other congregate settings have served to spread the coronavirus. But contact tracing efforts indicate that in Philadelphia, the virus is primarily spreading among household members, family members, and even small gatherings or travel with friends.

August 18, 2020

Blue Cross and Blue Shield of North Carolina’s value-based care program surpassed its year one goal of covering half of its eligible members with value-based care providers.

August 18, 2020

On June 19, 2020, CMS issued a proposed rule, “Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements”

August 17, 2020

Managed care organizations are in a unique position to develop strategies that would positively impact early diagnosis and treatment to lead to better outcomes and lower costs for patients, caregivers, and the healthcare system.

August 14, 2020

The COVID-19 pandemic has had many unintended consequences. In healthcare, one of the most significant may have been to show providers the advantages of alternative payment models instead of relying on fee-for-service payment.

August 13, 2020

In a webinar, experts outlined challenges providers face amid the coronavirus disease 2019 (COVID-19) pandemic and the benefits of increased access to high-value care during the outbreak and beyond.

August 12, 2020

Given the constraints prevalent post-COVID-19, Dr Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design, stresses that it is now more important than ever for the health care industry to prioritize payment reform.

August 11, 2020

COVID-19 has disrupted nearly every aspect of health care, including the momentum toward value-based payment reform.

August 11, 2020

Rural providers can pursue care transformation, such as expanding telehealth to allow the beneficiary’s place of residence to be an originating site.

August 11, 2020

The prognosis of COVID-19 on the US health care system may include yet another devastating outcome: delaying its transition to value-based care.

August 6, 2020

In the study, Chaiyachati and co-authors aim to evaluate the impact of the Community-Based Care Management program on total costs of care and utilization among adult high-need, high-cost patients enrolled in a Medicaid managed care organization.

August 5, 2020

With patients hesitant about care access, they are demonstrating interest in self-management, which could help providers transition to value-based care.

July 31, 2020

As states weather the economic hits from the coronavirus pandemic, some are setting their sights on Medicaid, in particular the rates paid to private managed care providers.

July 27, 2020

With Medicare Part B now covering all COVID-19 testing costs, and CMS also waving Medicare participation conditions, the system could come to a breaking point in a matter of years.

July 27, 2020

As more payers move to VBP models, the relationship between the two parties will continue to be adversarial. Will it be less combative with more transparency?

July 26, 2020

Home health providers that received more than $10,000 from the Provider Relief Fund will need to account for all of the grant funds they spent by Feb. 15 at the latest, the U.S. HHS announced earlier this week.

July 26, 2020

Over the years, home care providers that have provided specialized care have positioned themselves to stand out among their competitors. 

July 20, 2020

L.A. Care is supporting its safety-net providers during the pandemic through early payouts of value-based contracts and close partnerships with frontline workers.

July 15, 2020

Blue Cross Blue Shield of Massachusetts is launching a new payment model for small practices that combines value-based care and support payments.

July 14, 2020

The association urged CMS to modify the Medicare Shared Savings Program to protect providers from increased costs during the pandemic and opposed the cancelation of the program’s 2021 application cycle.

July 14, 2020

On June 17, CMS issued a proposed rule to grant state Medicaid programs and other payers flexibility to enter value-based payment (VBP) arrangements with drug manufacturers.

July 13, 2020

Overall, 75% of home care agencies did not track readmission rates at all in 2019, according to recently released data from Idaho-based market research and education firm Home Care Pulse.

July 13, 2020

Leveraging hospitalists, identifying obstacles, and creating a clinical strategy are key strategies for transitioning to value-based hospital medicine.

July 10, 2020

Neither safety net nor non-safety net hospitals showed improvements in the four infections analyzed, including after VBC was implemented.

July 7, 2020

According to CMS, the healthcare industry must change its payment structure to promote the overall health of patients and create incentives for doctors to keep patients healthy.

July 5, 2020

There’s a widening value-based care gap between larger home health providers and smaller mom-and-pop shops.

July 2, 2020

A new crop of healthcare startups are trying to shake up the $260 billion primary care market. It’s an industry that’s ripe for disruption, according to Canaccord Genuity healthcare analyst.

June 30, 2020

The pandemic has “thrown a wrench” into CMS’s “planning about continuing toward value-based care,” says Kevin Conroy, CFO at CareMount Medical in New York.

June 30, 2020

While value-based contracting was expected to stall during the pandemic, some payers see value-based care models as a lifesaver for independent provider partners.

June 30, 2020

Farzad Mostashari, MD, CEO of Aledade, discusses why physician practices that have leaned into value-based care have weathered the COVID-19 pandemic successfully.

June 16, 2020

Here are tips to help your children navigate some of the complicated emotions they may be facing with going back to school.

May 29, 2020

Many businesses are looking to their insurance program providers to help them manage, minimize and mitigate potential and actual losses as they weave their way through the haze of uncertainty and maze of confusion during this unprecedented time.

May 29,2020

Organizations receiving fee-for-service (FFS) payments have seen their revenues decline precipitously. This lack of capital affects their ability to adapt and respond to the pandemic.

May 27, 2020

While taxing, a newfound resourcefulness is something that will help home care providers re-envision home care moving forward and create change even after the coronavirus ends.

May 26, 2020

Telehealth exploded amidst the COVID-19 pandemic. But disparities in reimbursement for audio-only telehealth visits may have downstream implications for Medicare Advantage members.

May 26,2020

Providers that can adjust their business operations accordingly and keep up with the sweeping regulatory changes will have a massive advantage moving forward.

May 22, 2020

Accountable care organizations (ACOs) are seeking answers from the Trump administration over the status of the Next Generation ACO Model set to expire this year and the upcoming Direct Contracting Model.

May 19, 2020

In light of the coronavirus pandemic, ACOs should have until at least Oct. 31, 2020, to voluntarily exit the Medicare Shared Savings Program, nine industry groups said.

May 19, 2020

Virtual healthcare visits have increased during the coronavirus pandemic, kicking off a trend that will extend past the crisis.

May 18, 2020

COVID Innovation: Amid the COVID-19 outbreak, post-acute care organizations have had to pivot. Built-in flexibilities allow PACE organizations to relatively easily shift care into the home

May 18, 2020

A new survey shows that APM participants were more likely to leverage care management support for managing the COVID-19 surge, including triage call centers and remote patient monitoring

May 18, 2020

Even after the immediate emergency of the current COVID-19 pandemic passes, the healthcare industry won’t return to business as usual, experts say.

May 17, 2020

After an immense disruption from the COVID-19 virus led to a dip in patient visits and revenue, home-based care insiders are now reporting budding signs of normalcy.

May 10, 2020

Millions of Americans who suffer from hearing and vision loss are struggling to access critical health-care services. The CDC and WHO are trying to make information available to them.

May 7, 2020

Amidst the pandemic, more than 1 in 4 American adults met the criteria that psychologists use to diagnose serious mental distress and illness.

May 6, 2020

The COVID-19 pandemic is intensifying inequalities experienced by the world’s one billion people with disabilities.

May 5, 2020

Humana CEO Bruce Broussard said Tuesday that he expects telehealth and other changes embraced by the health-care sector during the coronavirus pandemic to have a lasting impact on how people go to the doctor.

May 5, 2020

A federal government waiver, issued early in March, expanded the use of federally funded health insurance — Medicaid, Medicare and the Children’s Health Insurance Program — to pay for telemedicine visits.

May 1, 2020

The risk of mental health problems increased during COVID-19. For many, especially young people, the online world can be a positive link to others in a similar situation or predicament.

April 26, 2020

Home care agencies navigating financial headwinds associated with the COVID-19 virus can seek relief through the Paycheck Protection Program (PPP).

April 24, 2020

With American facing unforeseen obstacles and concerned about their futures,  more than 60 million Americans with disabilities like her are facing perhaps the toughest road of all.

April 16, 2020

As the coronavirus continues to spread across the U.S., one might assume the home-based care industry is booming, due to providers’ special ability to keep vulnerable senior populations safely at home

April 15, 2020

The protocol for arranging telemedicine sessions varies by location, by practice specialty and by your ongoing history with a physician. Here are some common steps and tips to prepare for such a virtual visit.

April 14, 2020

Fifty-six percent of healthcare organizations that take on financial risk in Medicare Shared Savings Program contracts are likely to drop out of the program, according to a new survey from the National Association of ACOs.

April 14, 2020

As COVID-19 continues to upend care patterns and utilization, at-risk ACOs weigh exiting the MSSP and NextGen Model before they must repay CMS shared losses.

April 8, 2020

With U.S. public health experts warning of a cresting wave of coronavirus infections in the coming weeks, rates of transmission among the nation’s front-line fighters — doctors, nurses and other medical staff — are setting off alarm bells.

April 8, 2020

Although the burden of providing direct care and treatment of COVID-19 patients is falling on hospitals and other providers, payers will be bearing the costs of that care.

April 6, 2020

The coronavirus disease 2019 (COVID-19) pandemic will exacerbate the financial situations of the millions of Americans who struggle to afford their medical care, but policy solutions are available to quickly mitigate this problem.

April 1, 2020

With U.S. public health experts warning of a cresting wave of coronavirus infections in the coming weeks, rates of transmission among the nation’s front-line fighters — doctors, nurses and other medical staff — are setting off alarm bells.

April 1, 2020

Doctors in Italy who have seen COVID-19 decimate their hospitals issued a plea to American health care providers this week: care for people at home.

April 1, 2020

A new report warns of rising premiums and out-of-pocket expenses for beneficiaries resulting from healthcare spending to combat the global COVID-19 pandemic.

March 21, 2020

Marion Austin used to visit her husband John Austin every day at a nursing home in Rutland, Vt. Now, the couple of  70 years is keeping in touch via FaceTime.

March 17, 2020

The CMS on Tuesday approved Florida’s 1135 Medicaid waiver request, waiving specific Medicaid requirements to accelerate access to critical services in the fight against COVID-19.

March 13, 2020

Nursing facilities provide care to populations with those characteristics, and residents in these facilities are at risk of developing serious illness or dying if infected. 

March 9, 2020

Value-based care initiatives account for only a quarter of hospitals’ revenue, according to a recent survey of healthcare executives.

February 28, 2020

ACOs were developed to push the healthcare industry toward VBP. But the model is not the final solution, industry experts say.

February 27, 2020

States and Medicaid managed care organizations are experimenting with value-based payment models, but their policy choices come with difficult tradeoffs.

February 18, 2020

Decreasing the percentage of primary care delivered out-of-network across all ACOs by 0.1% could save Medicare $45M a year.

February 17, 2020

ACOs were developed to push the healthcare industry toward VBP. But the model is not the final solution, industry experts say.

February 14, 2020

Accountable care organizations play a critical role moving the care continuum toward value. But such complex contracting options make it challenging for ACOs to achieve success.

February 12, 2020

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 Change Healthcare and the HealthCare Executive Group.

February 10, 2020

Implementing advanced primary care models in a fee-for-service world is nearly impossible. A shift towards more holistic, patient-centered primary care requires health systems move towards value-based contracts.

February 10, 2020

Be it consumerism or interoperability, payers and providers are not seeing eye to eye. And when it comes to value-based care, there is an even bigger disconnect between the two according to the results of a new survey.

January 17, 2020

The healthcare industry has learned a lot from the past 10 years of payment reform for value-based care. Experts explore what the future holds for alternative payment models.

January 11, 2020

A group of senior healthcare leaders recently discussed the transformation from volume-based care to value-based care. This transition represents a huge change in incentives for health systems.

January 4, 2020

Primarily aimed at improving care quality and reducing costs, value-based payment programs have downstream effects on both care and business processes that can reduce administrative waste for payers and everyone they work with in delivering and financing care.

November 27, 2019

The AMA is dedicated to driving medicine toward a more equitable future, removing obstacles that interfere with patient care and confronting the nation’s greatest public health crises.

May 23, 2019

Physician groups are moving, albeit slowly, to value-based payment, but there are still many obstacles standing in their way.

April 30, 2019

From Chris Smedley
Vice President of Physician Enterprise
Premier Inc., comprehensive, personalized care focused on long-term patient needs is key to success.