Healthcare interoperability issues have always been confusing, changing, and difficult to address. The reason why is not straightforward: we have a fragmented health system with a myriad of specialized applications that are not universally used. Instead, we have a system where each organization elects which technology tools to use and in what configuration. Compounding this fragmented system is the push to value-based care (VBC). As more organizations shift their focus to VBC models, the need
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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Cigna & Fresenius Extend VBC Program to Help More People with Kidney Failure
What You Should Know: - Today, Fresenius Medical Care North America (FMCNA) and Cigna announced an expansion of their value-based care(VBC) program to improve health outcomes and lower the cost of care for those living with kidney failure, or end stage renal disease (ESRD), through at least 2023. - First launched in 2017 as part of Cigna Collaborative Care, the VBC program will now include additional incentives to support more kidney disease specialists
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Cricket Health Secures $83.5M to Expand Value-Based Kidney Care Model to Health Plans
What You Should Know: - Cricket Health, a San Francisco, CA-based provider of value-based kidney care with a clinically-proven approach to managing chronic kidney disease (CKD) and end-stage kidney disease (ESKD), today announced it has raised $83.5 million in Series B funding round led by Valtruis with a strategic investment from Blue Shield of California. The round also includes existing investors Oak HC/FT and Cigna Ventures, as well as K2 HealthVentures. - This new funding will help
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PE Firm WCAS Launches $300M Value-Based Care Portfolio Company, Valtruis
What You Should Know: Welsh, Carson, Anderson & Stowe (“WCAS”), a leading private equity firm focused exclusively on the healthcare and technology industries, announced that it is launching Valtruis, a unique portfolio company that will invest in and partner with value-based care driven healthcare companies. WCAS is committing an initial $300M to this platform. Founded on a commitment to accelerate meaningful change, Valtruis brings the functional expertise, access to capital and an
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ACLC, Innovaccer Jointly Launch Value-Based Care Collaborative
What You Should Know: - Innovaccer Inc., a San Francisco-based healthcare technology company, today announced its partnership with the Accountable Care Learning Collaborative (ACLC) to launch various initiatives promoting value-based care (VBC) in the industry. The ACLC is a nonprofit, peer-learning, member organization in which members work together to develop VBC competencies and build resources and tools for their peers. Together, Innovaccer and the ACLC will build a framework
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Humana Acquires Integrated Post-Acute Care Provider onehome – M&A
What You Should Know: - Humana Inc. announced that it has signed a definitive agreement to acquire integrated post-acute care provider One Homecare Solutions (“onehome”) from WayPoint Capital Partners (WayPoint), the private equity affiliate of a New York-based family investment office. - The acquisition will further advance Humana’s strategy to build a value-based home health offering. - Founded in 2013, onehome is a provider of a variety of home-based services, as well as a convener
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Why Provider-Payer Collaboration is the Secret to Value-Based Success
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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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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