The most effective way to reduce the amount of money our country spends annually on healthcare – which now exceeds $4.1 trillion – is to help people avoid becoming sick in the first place. That’s the fundamental premise of value-based care (VBC), which focuses on improving patient outcomes and quality of care while driving down costs.
VBC is great in intent and theory, but many provider organizations today are struggling to meet the quality and financial metrics stipulated under these
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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Unlocking Value-Based Care Through Accurate Provider Data
There’s no better illustration of the healthcare system’s data problems than this: 80% of entries in the nation’s five largest health plans were inaccurate as recently as last year. With a majority of patients relying on their health plan’s provider directory to select a physician, it’s not hyperbole to say incorrect provider data is dragging the entire industry down.
How can value-based care be realized when patients can’t find the provider information they need? Something as small as
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Promise of Value-Based Care Through Engagement and Outreach
The transformation of the healthcare landscape is undeniable. With the industry moving toward value-based care, the emphasis has shifted from volume of services to the actual value or outcome of care delivered. And while value-based care holds providers more accountable for results, it also grants resources and time to provide better, more patient-centric care.
But even years into the shift, no comprehensive guidebook for success remains. While providers are rewarded for higher-quality
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Optimizing MIPS Value Pathways (MVPs) for Oncology Practices in 2025
The Centers for Medicare and Medicaid Services (CMS) introduced the MIPS Value Pathways (MVPs) as part of its ongoing revisions to the Merit-Based Incentive Payment System (MIPS) program, which was established in 2017 to encourage ongoing and consistent quality, efficiency, and improvement in medical practices. The MVP framework was designed to ease the burden imposed on clinicians and their administrators who participate in the MIPS program. Traditionally, MIPS scores have been calculated based
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SOFHA and Lumeris Partner to Enhance Value-Based Care in Tennessee and Virginia
What You Should Know:
- State of Franklin Healthcare Associates (SOFHA), the largest employee-owned, physician-led multi-specialty primary care group in the nation, has announced a new partnership with Lumeris, a leading value-based care enablement company, to improve healthcare delivery and outcomes in Northeast Tennessee and Southwest Virginia communities beginning in 2025.
- By combining SOFHA’s exceptional provider care with Lumeris’ expertise in population health management and
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Arcadia: Transforming Healthcare with Data-Driven Solutions
What You Should Know:
- Arcadia® (arcadia.io), a leading data platform for healthcare, today announced the launch of two new solutions—Enhanced Benchmarks and Arcadia Vista Push—designed to help healthcare organizations improve value-based care performance and deliver actionable insights at scale.
- The company also detailed a product roadmap that sets the pace for innovation in healthcare analytics. These announcements set a vision for how Arcadia will bring solutions to market that are
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How AI Can Drive the Transition to Value-Based Care
The healthcare industry is at a crossroads, grappling with the dual challenges of declining health quality metrics and skyrocketing care costs. The reality is that health outcomes are driven more by what patients do than by what providers or payers do.
It is estimated that 80% of health outcomes are driven by non-medical factors – often social or behavioral risks that impact health and lead to poor outcomes and high costs. Value-based care (VBC) shifts this focus to helping the patient
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Value-Based Care is Growing – Is Your Data Ready?
The famous quote “What gets measured, gets managed” is often incorrectly attributed to business guru Peter Drucker. Although Drucker may not believe that maxim entirely, when it comes to value-based care (VBC), only care quality that can be measured and reported matters.
Whether it is capitated, bundled, pay-for-performance, or hybrid VBC reimbursement models, the Centers for Medicare and Medicaid Services (CMS) and other payers typically have significant demands regarding quantitative data
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Navigating 2024 Healthcare Challenges: Policy, AI, and the Road Ahead
Now that we’re halfway through 2024, we’ve gained significant insights into the most pressing healthcare issues facing our industry and how they might shape the future. From regulatory hurdles to technological advancements, our sector is at a pivotal juncture, and understanding these dynamics will be crucial for all stakeholders involved.
Here are some of these key challenges and explore the strategies that could help guide us through the rest of the year.
Challenges on the Horizon:
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Humana, Interwell Health Expand Value-Based Kidney Care Agreement to Florida
What You Should Know:
- Humana Inc., a health and well-being company, and kidney care management company Interwell Health are expanding their value-based care agreement to include Florida.
- The expansion will provide eligible Humana Medicare Advantage members living with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) in Florida with access to Interwell’s comprehensive care and specialized resources.
Value-Based Care for Improved Outcomes
Value-based
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