As healthcare moves from a fee-for-service model to a value-based care (VBC) model, many providers are having to reengineer aspects of their business. "Value-Based Care. Making the Shift: Who Can Help?" is the first report published about this market segment by KLAS. The report found that Advisory Board, Conifer and Evolent scored high with providers in giving them confidence to deal with evolving alternative payment models and preparing for future risk.
Top Firms for VBC Consulting/Management
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Healthcare Reform| Health Reform | Policy, News, Analysis, Insights - HIT Consultant
AMIA Urges CMS to Rethink Informatics Policies as New Models of Care Emerge
In comments submitted to the Centers for Medicare & Medicaid Services (CMS), the nation’s leading data scientists in healthcare urged federal officials to use new payment policies to reassess how providers are required to use informatics tools, and rethink how quality is measured in a digital world. Officials from the American Medical Informatics Association (AMIA) said new and novel ways to deliver care will rely on dynamic uses of information technology (IT) and other informatics tools, so
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3 Trends Driving Medicare Towards Bankruptcy
The 50-year old Medicare program is not aging well; and that’s not good news for seniors, according to a new report by National Center for Policy Analysis Senior Fellow Devon Herrick. When President Johnson signed the Medicare program into law on July 30, 1965, no one anticipated the program to grow at the rate it has. In 2014, the Medicare program spent over $613B to cover healthcare for 54 million beneficiaries. The law states that seniors do not qualify for Medicare until age
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Healthgrades: 1 in 6 Patients Receive Care In 1-Star Rated Hospitals
1 out of every 6 patients in the U.S. received care in a hospital rated 1-star[1], according to new research released by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. Had those patients researched local doctors and hospitals to identify and select a physician practicing in a 5-star hospital for their specific procedure or condition, they would have faced a 71 percent lower risk of dying or a 65 percent lower risk of experiencing
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3 Medicare Reforms That Could Keep Seniors Healthier, Wealthier
Empowering seniors to take control of their own health spending and rewarding the doctors who coordinate patients’ care, as well as the providers that reduce patients’ costs and improve the quality of their treatment, could vastly improve the health of seniors on Medicare, according to a new report by National Center for Policy Analysis Senior Fellow Devon Herrick. Medicare reform requires empowering seniors to manage more of their own health care spending using Medicare Health Savings Accounts
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Physicians Reveal Lack of Time As Greatest Challenge in Caring for Chronic Care Patients
As healthcare shifts to value-based care, there is growing emphasis on helping patients with chronic conditions better manage their health. Patients with two or more chronic conditions – such as heart failure, diabetes and asthma – make up more than two-thirds of the entire Medicare population. And caring for these patients requires extra time – something most physicians don’t have. Physicians looking to bring more personalized care to their practices report difficulties implementing the
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Aetna to Buy Humana for $37B, Largest Insurance Deal Ever
Health care-insurance giant Aetna has agreed to acquire smaller rival Humana for $37 billion in cash and stock making it the largest ever deal in the insurance industry. The rapid consolidation in the U.S. health care industry. brings together Humana’s growing Medicare Advantage business with Aetna’s diversified portfolio and commercial capabilities to create a company serving the most seniors in the Medicare Advantage program and the second-largest managed care company in the nation.
Under
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King v. Burwell: 5 Key Trends Driving Consumer-Focused New Health Economy
Today, the Supreme Court affirmed the 4th Circuit, holding that tax credits are available in states using the federal exchange. PwC's Health Research Institute (HRI) performed an analysis of publicly available information - including ACA enrollment data and CMS data on hospital spending - to assess the financial impact of the loss of subsidies in the federal marketplace. The Court’s decision in King v. Burwell removes uncertainty for some 8 million Americans who were at risk of losing coverage
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PwC: Healthcare Spending Growth Rate to Dip 6.5% in 2016
Spending growth in the $2.9 trillion US health economy is expected to slow in 2016 as compared to 2015; however, it will still outpace overall economic inflation. Stock prices, earnings reports and the customer base have increased and that means the industry is financially healthy. Sadly, affordable healthcare remains out-of-reach for many consumers.
PwC’s Health Research Institute (HRI) projects the U.S. healthcare spending growth rate will dip to 6.5 percent in 2016, capping a
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Parity Not Apparent: There Is No Biopsy for Mental Illness
Getting legislation through Congress—often a monumental battle—is one thing. But implementing new laws may be a greater challenge simply because they require so much sustained energy and attention.
Take mental health parity laws, for example.
Congress passed the Mental Health Parity Act (MHPA) championed by Sens. Paul Wellstone (D-MN) and Pete Domenici (R-NM) in 1996. The law prohibits employee-sponsored group health plans from charging more in a year or over a lifetime for mental health
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