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March 16, 2021

The North Carolina Department of Health and Human Services opened enrollment for NC Medicaid Managed Care Monday. The new plans will go into effect July 1. About 1.6 million Medicaid recipients will be eligible for the new choice-driven program.

March 16, 2021

The agency shared the final list of participants approved for the new ambulance provider APM as well as a $34M funding opportunity for states to expand emergency medical triage services.

March 10, 2021

As gene therapies become more widespread, payers continue to rely on proven strategies to reduce gene therapy healthcare spending, CVS Health’s Health Trends Report 2021 explained.

March 4, 2021

One of the biggest home health providers in the country is teaming up with one of the nation’s largest home care organizations.

March 3, 2021

The Department of Health and Human Services in collaboration with the Centers for Medicare & Medicaid Services and the Office of the Inspector General has issued two final rules clarifying certain regulatory terms.

March 3, 2021

An eclectic group of health care providers has formed a new organization dedicated to advancing home-based care.

March 1, 2021

Nationally, the number of children under age 21 enrolled in Medicaid grew from 23.5 million in 2000 to 40.5 million in 2017.

February 26, 2021

The health system and payer are joining forces to offer Medicare Advantage patients access to Mercy’s telehealth center. They also plan to implement a value-based payment model.

February 24, 2021

The pace and pressure to embrace value-based care are picking up.

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.