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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant

Elevating Healthcare Through Risk Stratification: Lessons from North Carolina’s Value-Based Initiatives

by Kevin Riley, CEO and President & Sheena Ming, Clinical Success Consultant at Zyter|TruCare 02/01/2024 Leave a Comment

Elevating Healthcare Through Risk Stratification: Lessons from North Carolina's Value-Based Initiatives

As the healthcare landscape continues to evolve, there's a clear trend towards value-based care (VBC). This significant shift, which places a premium on patient health outcomes, diverges from the traditional fee-for-service approach. The aftermath of the COVID-19 pandemic has mainly catalyzed the adoption of VBC models, highlighting the importance of care quality and effectiveness rather than the sheer volume of services. This change reshapes healthcare, aligning it more closely with patient
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Ohio State & CVS Form ACO to Elevate Medicare Care in Central Ohio

by Syed Hamza Sohail 01/25/2024 Leave a Comment

Ohio State & CVS Form ACO to Elevate Medicare Care in Central Ohio

What You Should Know: The Ohio State University Wexner Medical Center and CVS Accountable Care, part of CVS Health® (NYSE: CVS), today announced the creation of an accountable care organization (ACO) to improve the quality of care for Medicare beneficiaries by Ohio State providers in central Ohio.This coordinated approach to delivering care is centered around each patient’s unique needs and emphasizes preventive wellness and proactive treatment of chronic conditions. CVS ACO and
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FQHCs Shine in Value-Based Care: MHN Partners Achieve $10M Savings and Perfect Quality Score

by Fred Pennic 12/22/2023 Leave a Comment

What You Should Know: - Medical Home Network (MHN), a leading care enablement partner for FQHCs, announced that its partners participating in the NeueHealth Premier ACO achieved $10.1 million in gross savings and a perfect 100% quality score in the 2022 performance year. - This accomplishment, under the ACO Realizing Equity, Access, and Community Health (REACH) Model, involved 20 FQHCs across Ohio, Missouri, and Illinois serving approximately 10,000 Medicare beneficiaries. The success
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Patients Crave Conversational Texting, Frustrated by Simplistic Healthcare Communication

by Jasmine Pennic 12/19/2023 Leave a Comment

What You Should Know: - A new survey by Artera, a leader in patient communication technology, reveals a stark disconnect between how healthcare providers communicate and what patients actually want. - The findings, based on responses from over 2,000 patients, paint a picture of frustration and missed opportunities, with simple phone calls and one-dimensional text messages falling short of patient expectations. Communication Breakdown - Nearly half (45%) of patients have missed or forgotten a bill due to communication difficulties with their provider's office. - 43% report negative health impacts from communication challenges, including issues scheduling appointments or sharing crucial information. - A staggering 79% of patients want providers to offer text-based conversation on any topic, highlighting a desire for more convenient and accessible communication. Texting: A Double-Edged Sword - While 77% find automated text exchanges valuable, simplistic "yes/no" interactions dominate, frustrating 69% of patients who long for deeper conversations. - Two-thirds report incomplete text experiences, with 31% failing to achieve their goals at least half the time, often resorting to phone calls. - Technical glitches and unanswered messages further exacerbate the problem, with 62% experiencing error messages, invalid responses, or radio silence from providers "half the time" or more. Financial and Human Costs - Providers failing to meet communication expectations face financial consequences, as 59% of patients are willing to switch doctors due to poor communication. - Artera's research sheds light on the impact on healthcare workers as well, with a December 2022 report finding outdated communication strategies contributing to staff burnout. Guillaume de Zwirek, CEO and Founder of Artera, emphasizes the importance of patient-centric communication: "As a $4 trillion market, healthcare should offer unmatched customer experience. If patients can't communicate seamlessly, they won't engage, leading to a sicker population and more expensive care long term."

What You Should Know: - A new survey by Artera, a leader in patient communication technology, reveals a stark disconnect between how healthcare providers communicate and what patients actually want. - The findings, based on responses from over 2,000 patients, paint a picture of frustration and missed opportunities, with simple phone calls and one-dimensional text messages falling short of patient expectations. Communication Breakdown - Nearly half (45%) of patients have missed or
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What Patients Want: Zocdoc’s Report Reveals Patient Preferences

by Fred Pennic 12/14/2023 Leave a Comment

What Patients Want: Zocdoc's Report Reveals Patient Preferences

What You Should Know: - Zocdoc, the healthcare marketplace, has released its inaugural What Patients Want Report, offering valuable insights into what patients seek from their healthcare experience and providers. - Based on millions of bookings and patient interactions, the report paints a picture of how patients are navigating the healthcare landscape today, and what they expect from their providers and the industry at large. Key findings of the report include: Women driving
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Clover Health Exits CMS ACO REACH Program to Focus on Medicare Advantage

by Fred Pennic 12/01/2023 Leave a Comment

Clover Health Exits CMS ACO REACH Program to Focus on Medicare Advantage

What You Should Know: - Clover Health, a physician enablement company committed to bringing access to great healthcare to everyone on Medicare announced that it has delivered notice to the Centers for Medicare and Medicaid Services (“CMS”) that it will exit the CMS ACO REACH Program at the end of the 2023 performance year. - Written notification will also be sent to all participating physicians in accordance with CMS requirements. - The decision will have no impact on its ACO REACH
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NextGen’s Value-Based Care Solutions Unlocks $82M in Medicare Savings

by Syed Hamza Sohail 11/21/2023 Leave a Comment

NextGen’s Value-Based Care Solutions Unlocks $82M in Medicare Savings

What You Should Know: NextGen Healthcare, Inc. a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year.The MSSP incentivizes hospitals, associations of physicians, and other healthcare facilities to form accountable care organizations (ACOs) that
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Mobile Pay Revolutionizes Specialty Groups: Unlock the Data-Driven Potential

by Janet Carbary, CFO of Integrated Rehab Group, 11/20/2023 Leave a Comment

Mobile Pay Revolutionizes Specialty Groups: Unlock the Data-Driven Potential

It’s no surprise that healthcare is doubling down on software investments for healthcare revenue cycle, including software with an AI component, like predictive analytics. What’s unique is that right-now value from AI in revenue cycle is happening outside the walls of a healthcare facility or medical practice. In fact, it’s originating from the device patients use most: their smartphone. For specialty groups in particular, the ability to successfully engage patients in their financial
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NorthShore – Edward-Elmhurst Health Signs Largest VBC Deal in 5 Years

by Fred Pennic 11/02/2023 Leave a Comment

NorthShore – Edward-Elmhurst Health Signs Largest VBC Deal in 5 Years

What You Should Know: - Edward-Elmhurst Health (NS-EEH) has announced a significant, long-term partnership with Lumeris, a pioneer in value-based care (VBC). This partnership is a major development in the healthcare industry, representing the largest VBC provider deal since 2018. - With rising expenses outpacing reimbursement rates, health systems and physician organizations are increasingly turning to value-based care to avoid layoffs and service cuts. NS-EEH, the third largest healthcare
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UnitedHealthcare, RUSH Health Form Medicare Advantage Relationship

by Fred Pennic 10/24/2023 Leave a Comment

UnitedHealthcare, RUSH Health Form Medicare Advantage Relationship

What You Should Know:  - UnitedHealthcare and RUSH Health announced a new relationship that will give UnitedHealthcare Medicare Advantage plan members network access to all RUSH Health locations in Illinois for the first time, effective immediately.  - The multi-year agreement, effective Oct. 1, provides UnitedHealthcare Medicare Advantage plan members with enhanced access to quality care and provides a new option as they choose which health plan best meets their healthcare needs
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