The staggering reality that health care could soon account for one fifth of all domestic spending has put a bull’s eye on health care cost control. Is your ACO, health system, or physician organization ready to manage the coming congressional budget cuts? The only effective way to tackle Total Costs of Patient Care (TCoC) without cutting services is through a curated value-based care approach. Here are the fundamentals you need to know and five strategic steps to
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value-based arrangements
Humana Issues New Brief on Value-Based Care for Kidney Disease
What You Should Know:
- Health insurance provider Humana Inc. announced the release of a groundbreaking Value-Based Care (VBC) Issue Brief focused on nephrology, the medical specialty treating kidney disease.
- The issue brief report highlights the significant potential of VBC arrangements to improve patient outcomes and reduce healthcare costs for individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD).
VBC: A Shift from Quantity to Quality
VBC
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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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MedArrive, Ouma Partner to Bring In-Home Maternal Care to Vulnerable Medicaid Members
What You Should Know:
- MedArrive today announced its collaboration with Ouma, one of the most mission-driven maternal health companies in the nation, which has the largest DTC network of maternal-fetal medicine providers (and other care specialists).
- The collaboration aims to improve the health of pregnant women and their newborns, especially those at high risk, by adding a vital service to MedArrive’s growing ecosystem of specialty care providers that managed
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Evergreen Nephrology Taps Innovaccer to Transform Kidney Care
What You Should Know:
- Evergreen Nephrology, a nephrology-focused value-based care organization, has chosen the Innovaccer® Health Cloud and Innovaccer’s full solution suite to accelerate the transformation of kidney care.
- Innovaccer’s cloud-native solutions selected by Evergreen include tools to optimize care management, physician engagement, patient engagement, referral management, advanced analytics, and dashboard-driven insights to optimize delivery of value-based specialty
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5 Things to Consider Before Implementing a CAPS System in 2023
Core administrative processing systems (CAPS) serve as the center of the healthcare payer architecture and are essential for efficient business operations. These systems are needed to support administrative and transactional processing and are a significant investment in technology. Selecting a CAPS system isn’t a single purchase, but rather an ongoing partnership that requires maintenance to ensure the system remains up to date to support industry and regulatory changes. Last year, 99% of
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3 Elements Required for Data Ecosystems to Drive Innovation
For years, the healthcare industry has been inundated with stories about the importance of sharing data among payers, providers, and other key stakeholders – and for a good reason; widespread interoperability of healthcare data has the potential to transform much of the industry for the better.
What's often not mentioned is how expensive, time-intensive, and potentially legally hazardous data-sharing is. Combining disparate data sets is a technically challenging undertaking that requires
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UpStream Raises $140M to Expand Value-Based Care Model Nationwide
What You Should Know:
- Value-based care provider UpStream raises $140M in Series B funding co-led by Coatue and Dragoneer with additional participation from other top healthcare and technology investors, including Avidity Partners, Define Ventures and Mubadala. This round brings its total funding to nearly $185M to date.
- UpStream supports physicians operating under full-risk, value-based arrangements who are providing care to seniors on Medicare with an integrated platform that
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Should I Get Another Booster? How Doctors Can Help Patients Navigate the Next Phase of COVID-19
The general consensus is that COVID-19 in some form is here to stay. As people come to terms with this reality, primary care providers may be getting more questions from patients – especially older and immunocompromised ones – asking for advice on how to handle different situations. Should I get another booster? Can I start traveling? Is it OK to go to a wedding next weekend? How cautious do I need to be in social settings?
The answers to these questions aren’t always clear. A lot depends on
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Should I Get Another Booster? How Doctors Can Help Patients Navigate the Next Phase of COVID-19
The general consensus is that COVID-19 in some form is here to stay. As people come to terms with this reality, primary care providers may be getting more questions from patients – especially older and immunocompromised ones – asking for advice on how to handle different situations. Should I get another booster? Can I start traveling? Is it OK to go to a wedding next weekend? How cautious do I need to be in social settings?
The answers to these questions aren’t always clear. A lot depends on
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