Just before the COVID-19 pandemic emerged, 48% of healthcare providers surveyed said three-quarters of their organization’s payments were grounded in fee-for-service models of care. Fast forward a year and the financial aftershocks of the pandemic have highlighted some of the benefits of value-based models for providers as well as health plans and consumers. Despite the benefits of incentive-based payment models in healthcare, including indications that it may reduce readmissions and
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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Applying A Hedge Fund Mentality for Investing in Social Determinants of Health
While I am a practicing clinician, I am a firm believer that improvements in healthcare most often come from borrowing the best ideas from other business models. For example, I have sometimes borrowed from software company and payer colleague insights to describe value-based care (VBC) reimbursement as a subscription model. This model would provide more consistent revenue and allow organizations to better weather challenging times like a pandemic. For providers, this would allow freedom from the
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The Crucial Role of SDOH Data in Value-Based Care
Roughly $4 trillion is spent on healthcare annually in the U.S. Despite this massive expenditure, roughly 80% of health outcomes are attributed to social, behavioral and environmental factors, known as social determinants of health (SDOH). What has been far less clear is how providers and payers can fully harness SDOH data to proactively manage the health of patients and members. Technological and cultural barriers have made it difficult for disparate parties such as
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One Medical Acquires Value-Based Primary Care Group Iora Health for $2.1B – Health M&A
What You Should Know: - Today, One Medical (NASDAQ: ONEM) announced its intent to acquire Iora Health, a value-based primary care group for serving roughly 38,000 Medicare patients through digital health and 47 in-person medical offices in ten markets across the United States for about $2.1B in stock. - Iora Health’s relationship-driven primary care model focuses on relationships to improve health outcomes and significantly lower costs than the traditional healthcare system. -
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What Population Health Management Providers Need to Know About HITRUST CSF Certification
Healthcare companies continue to implement value-based care and population health management initiatives to coordinate healthcare delivery and improve the quality and value of patient care. These initiatives depend on the ability to access, aggregate, and analyze massive amounts of patient data, often coming from hundreds of source systems. Critical system interoperability and data-sharing agreements enable healthcare organizations to aggregate data and build massive data assets to support their
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Finetuning Quality Measure Reporting to Perform Like Professional Athletes
Healthcare organizations deal with a seemingly endless list of demands, including expanding access to care, financial sustainability, staffing shortages, rigorous data security, government regulations and quality improvement initiatives. Many organizations can operate at full speed and still find they cannot keep up with all the demands. Quality programs facilitated by CMS and commercial health plans provide critical funding to support healthcare operations. They require diligent data
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As CMS Delays CHART, Rural Providers Need to Take Value-Based Care into Their Own Hands
The answer to solving a healthcare crisis that exacerbates barriers to care among some of the most vulnerable patient populations in the country is staring us in the face. For rural hospitals straining under the weight of erratic patient volumes, sicker populations and lack of funding, the path forward is in value-based care. But providers can’t stand idly by waiting for the government to step in and help them make that change. They need to save themselves. That may sound like a big lift for
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Zing Health Acquires Medicare Advantage Plan Provider Lasso Healthcare
What You Should Know: - Zing Health Enterprises, a physician-founded and led provider of Medicare Advantage health plans, has signed definitive documents to acquire Harrisburg, PA-based Lasso Healthcare Insurance Co. - Lasso Healthcare offers Medicare Advantage (MA) plans in 34 states and the District of Columbia. Its insurance offerings currently cover over 6,000 members. Lasso Healthcare offers a pioneering consumer-directed Medicare Advantage product, called a Medicare Medical Savings
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Eleanor Health Secures $20M for Value-Based Addiction and Mental Health Treatment
What You Should Know: - Eleanor Health, a Waltham, MA-based outpatient addiction and mental health provider delivering convenient and comprehensive care through a population and value-based payment structure, today announced it has closed an oversubscribed $20M Series B financing. The round included participation from all existing investors including Town Hall Ventures, Echo Health Ventures, and Mosaic Health Solutions, as well as new participation from Warburg Pincus. - Committed to
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Why Healthcare Data Won’t Magically Create Value-Based Care
The conversation about transitioning the American healthcare system from fee for service (FFS) to value-based care (aka, pay for performance) has been going on for more than 15 years. Still, it felt like time travel to come across a Health Affairs book review from 2006 by the late Princeton Professor Uwe Reinhardt that could have been written last month. In evaluating what he describes as the “utopian vision” laid out in Michael Porter and Elizabeth Teisberg’s Redefining Health
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