Is value-based care still the right strategy to reduce U.S. healthcare costs? Or is it time to move to what comes next in the generation-long battle to constrain total medical spending?
The question is being increasingly asked and with good reason. For 2024 medical costs are projected to rise 7.0% year over year for Individual and Group markets. That is greater than the medical cost trend in 2022 and 2023, which was 5.5% and 6.0%, respectively, and adds to a decade-plus of at least 5.5% per
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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant
Strategic Cost Management Ensures ACO Viability
For ACOs to remain relevant as leaders of Value-Based payment models, they must step up now to generate more cost savings for Medicare patient care. Budget cuts for Medicare are once again under discussion by conservatives as political pressure mounts to lower governmental spending. Meanwhile, CMS is expanding risk in Medicare value-based payment models, moving quickly away from Fee-for-Service reimbursement. The new ACO PC Flex model is designed to create per-patient reimbursement for
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MEDITECH Launches Nationwide HIE Interoperability Network for U.S.
What You Should Know:
- MEDITECH launches Traverse Exchange, a new nationwide health information exchange (HIE) network designed to facilitate secure and efficient sharing of patient data among healthcare providers.
- Built on the foundation of the successful Traverse Exchange Canada, the new platform enables MEDITECH customers to exchange health information with other MEDITECH organizations and external systems that adhere to interoperability standards.
Transverse Exchange:
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Navigating the Final CMS Medicaid Managed Care Rule (CMS-2439-F)
On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final rule, Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality. The rule aims to promote consistency and transparency, with an increased focus on improving access, driving quality, and advancing equity for Medicaid beneficiaries. CMS has been moving in this direction for several years, and states managed care organizations, and providers have
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Astrana Health Acquires Collaborative Health Systems to Expand Care Delivery Network
What You Should Know:
- Astrana Health, a leading technology-powered healthcare company acquires Collaborative Health Systems (CHS), a management services organization serving over 129,000 beneficiaries across 17 states.
- The strategic move will significantly expand Astrana’s care delivery capabilities and solidify its position as a key player in the value-based care market.
Expanding Geographic Footprint and Enhancing Care Delivery
CHS brings a strong
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Astrana Health and Elation Health Partner to Build Value-Based ACOs, CINs
What You Should Know:
- Astrana Health (NASDAQ: ASTH), a provider-centric healthcare company, today announced a strategic partnership with Elation Health, a clinical-first technology company specializing in primary care.
- The partnership focuses on supporting independent physicians by providing them with the tools necessary to thrive in value-based care arrangements. Astrana and Elation plan to establish risk-bearing entities, such as accountable care organizations (ACOs) and
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Why Patient Engagement Must Be at the Center of Value-Based Care
In the dynamic and ever-changing landscape of the healthcare industry, patient engagement continues to emerge as a pivotal element of the value-based care (VBC) model. Value-based care seeks to improve health outcomes by leveraging the Quintuple Aim framework – focusing on the patient experience, population health success, cost reduction, team wellbeing, and health equity. Value-based care models center on patient outcomes and how well healthcare providers can improve the quality of care based
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JAMA: Traditional Medicare Is, In Fact, The Failure
What You Should Know:
- A new article published in JAMA Internal Medicine reignites the debate about Medicare Advantage and traditional Medicare.
- Dr. Sachin H. Jain, CEO of SCAN Group and SCAN Health Plan, argues in favor of Medicare Advantage, while Drs. Adam Gaffney, David Himmelstein, and Steffie Woolhandler advocate for traditional Medicare.
Traditional Medicare: Lower Costs, Fewer Benefits
Traditional Medicare offers beneficiaries lower premiums, but it comes with
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How Skilled Nursing Facilities Can Navigate New Value-Based Purchasing Rules
Post-acute care facilities for years have been preparing for the impact that value-based purchasing (VBP) programs would have.
The Affordable Care Act of 2010 (ACA) and the Medicare Access and CHIP Reauthorization Act of 2015 put providers on notice that quality of care measures, like reducing hospital readmissions and improving patient outcomes, would take precedence over fee-for-service models.
In 2024, the stakes have gotten much higher for post-acute care facilities. Understanding
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Beyond the EHR: Why We Need a Patient Communication Layer
Healthcare looks a lot different than it did a few years ago. Healthcare leaders need to address rising consumerism, persistent labor shortages, systemic equity gaps, and a critical shift toward value-based care.
It’s worth asking: If the healthcare landscape has changed so much, why do foundational electronic health record (EHR) systems stand largely unchanged?
Sure, the walled gardens surrounding the EHR have dropped a bit, as the EHR giants have been badgered into interoperability
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