There is an adage that change in healthcare moves at the speed of tectonic plates. The slow adoption of Alternative Payment Models (APMs), the central feature of value-based care, is a good example of constraint despite immense pressure to control costs. Data from 2020 demonstrate almost zero change from 2018 in the proportion of straight Fee-for-Service (FFS) reimbursement. Other results show a slight uptick in APMs with or without downside risk at 34.6 percent. However,
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Innovaccer Expands into Public Sector to Accelerate Public Health Transformation
What You Should Know: - Health cloud company Innovaccer Inc, today announced it is expanding into the public sector to improve collaboration between agencies, optimize case management, manage increasingly complex alternative payment models, and improve the individual’s experience through technology. - The Innovaccer Health Cloud’s Data Activation Platform (DAP) collects, cleans, and connects data, making it available and shareable between systems to accelerate digital
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HSBlox Releases Enhanced VBC Contract Builder
What You Should Know: - HSBlox, a technology company empowering healthcare organizations with the tools and support to deliver value-based care (VBC) successfully and sustainably, today announced Release 3.5 of its CureAlign platform. - CureAlign enables healthcare organizations to administer value-based programs, including network build-out, contract administration, permissioned data exchange and payment. CareAlign 3.5 Overview CureAlign 3.5 further
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COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever
In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need to provide healthcare for all in the event of calamity upending the basic functions of a civilized society. With that, the UK’s National Health Service (NHS) was born. In 2020, all perspectives about quality and the time it takes to see a provider aside, the NHS remains quite popular
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How AI-Driven Insight Could Fuel Medicare Advantage Success
Medicare Advantage plans need more than consumer-centric design, payer/provider alignment, and strong connections across the continuum of care to drive value. The high-value performance also depends on their ability to use data to make a meaningful difference in members’ health. With 11,000 people aging into Medicare daily, proficiency in managing Medicare Advantage populations is critical for demonstrating value in a competitive market. Enrollment in these plans is growing significantly,
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3 Trends Driving Healthcare Mergers & Acquisitions (M&A) Activity in 2020
Livingstone’s
Ryan Buckley shares insights behind the prevalent healthcare M&A trends of
2020 and its impact on U.S healthcare. The New
Year often brings with it an essence of transformation. This year, U.S.
healthcare’s metamorphosis is now more than a decade old, as it continues to
shed its antiquated legacy systems and siloes to embrace a different kind of entity—one
that hopes to establish weight in value-based care at a scale robust enough to
substantiate it.
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How Value-Based Care is Changing the Way You Build Digital Health Companies
After years of talk, fee-for-service payment models are finally being challenged in a real way. With value-based care, providers are reimbursed based on patient health outcomes rather than the number of patients they see, which has begun to pass the burden of cost from insurers and employers to providers and patients.
Fundamentally, value-based care requires vendors as well as providers to operate differently, but new revenue models and a new approach to hiring deserve special consideration. In
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Physician Practices Strategy to Developing A Strong Chronic Care Management (CCM) Program
More than three years have passed since the Centers for Medicare & Medicaid Services (CMS) introduced its separately billable non-face-to-face Chronic Care Management (CCM) service. This was intended to help more than two-thirds of individuals on Medicare who suffer from multiple conditions receive more coordinated, regular primary care. The hope was that a focus on managing chronic conditions would contribute to better outcomes for overall population health, improve individual access to
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AMA-RAND Study: Physician Payment Models are Becoming More Complex
According to a new joint study by the RAND Corporation and the American Medical Association, physician payment models are becoming more complex and the pace of change is increasing, creating challenges for physician practices that might hamper their ability to improve the quality and efficiency of care despite their willingness to change.The study is a follow-up to a similar one conducted in 2014 to assess how physician practices were responding to alternative payment models. These models are
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5 Barriers to Achieving Success In Value-Based Care, Alternative Payment Models
Premier recently published a white paper titled Building Successful Two-Sided Risk Models, which discusses evolving risk-based alternative payment models and uncovers insights around the capabilities health systems need to achieve success in today’s value-based payment environment. A recent Premier C-Suite survey identified five barriers to achieving success in value-based care, alternative payment models: 1. Balancing health system margin pressure from both managing participation in
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