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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant

Closing Care Gaps Through Prospective Risk Adjustment

by Sachin Patel, Chief Executive Officer, Apixio 03/21/2024 Leave a Comment

Improving Patient Outcomes, Regulatory Compliance, and Financial Sustainability at the Point of Care

The lack of a complete and comprehensive patient record limits the ability of the physician to improve care and puts organizations at financial and regulatory risk. The Centers for Medicare and Medicaid Services (CMS) estimated that for payment year 2018 alone, it will recover $428.4 million (net) and $4.7 billion from 2023 through 2032, including extrapolation effects. The HHS Office of Inspector General (OIG) recently reported that, from October 2014 through December 2016, 153 audit reports
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Unlocking the Potential of Value-Based Care with AI

by Jay Ackerman, CEO, Reveleer 03/18/2024 Leave a Comment

Unlocking Value-Based Care: How AI Can Overcome Key Challenges

The momentum of value-based care (VBC) is poised to accelerate. The Centers for Medicare and Medicaid Services (CMS) has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030, a notable increase from the mere 7% recorded in 2021 by Bain Research. As more plans, providers and members enter VBC arrangements, substantial volumes of clinical data will need to be managed effectively to oversee patient risk and care quality.  The
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Thyme Care Launches VBC Platform w/ 400+ Oncologists

by Jasmine Pennic 03/13/2024 Leave a Comment

Thyme Care Launches VBC Platform w/ 400+ Oncologists

What You Should Know: - Thyme Care, a leader in value-based cancer care, has launched Thyme Care Oncology Partners (TCOP), a dedicated platform designed to support oncology practices in the transition to value-based care models. - Through partnerships with payers and providers, Thyme Care's TCOP platform fosters collaboration and prioritizes patient-centric care while reducing costs. This innovative approach positions Thyme Care as a leader in shaping the future of value-based cancer
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Innovaccer Acquires Pharmacy Quality Solutions to Bolster Value-Based Care Initiatives

by Jasmine Pennic 03/12/2024 Leave a Comment

Innovaccer Acquires Pharmacy Quality Solutions to Bolster Value-Based Care Initiatives

What You Should Know: - Innovaccer, a healthcare IT company, announced today the acquisition of Pharmacy Quality Solutions (PQS), a leader in Pharmacy-Payer performance technology. - By leveraging PQS's strengths, Innovaccer is poised to play a leading role in shaping the future of value-based care and medication management within the healthcare landscape. Enhancing Value-Based Care The acquisition positions Innovaccer to play a more significant role in the transformation of
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Chamber Secures $8M to Empower Cardiologists to Transition into Value-Based Care

by Fred Pennic 03/06/2024 Leave a Comment

Chamber Secures $8M to Empower Cardiologists to Transition into Value-Based Care

What You Should Know: - Chamber Cardio (Chamber), a groundbreaking healthcare company designed to support cardiologists in the transition to value-based care raises $8M in seed funding led by General Catalyst, with participation from existing investor AlleyCorp and additional support from Company Ventures, American Family Ventures, and City Light. - By providing technology-enabled support and a deep understanding of value-based care, Chamber empowers cardiologists to deliver high-quality
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Humana & Strive Health Offers Value-Based Kidney Care to More Medicare Advantage Members

by Jasmine Pennic 03/05/2024 Leave a Comment

Humana & Strive Health Offers Value-Based Kidney Care to More Medicare Advantage Members

What You Should Know: - Humana Inc. (NYSE: HUM) and kidney care provider Strive Health announced today a new multi-state, value-based care agreement for kidney care to more Medicare Advantage members. - This expanded value-based kidney care partnership extends access to Strive's innovative kidney care model to Humana Medicare Advantage HMO and PPO plan members living with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) across five states. Transforming Kidney Care
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Only 37% of Medical Practices Receive Value-Based Care Payments, Black Book Survey Reveals

by Fred Pennic 02/23/2024 Leave a Comment

Only 37% of Medical Practices Receive Value-Based Care Payments, Black Book Survey Reveals

What You Should Know: - While the shift towards value-based care (VBC) is underway, a recent Black Book survey reveals that only 37% of medical practices are currently receiving payments from upside-risk arrangements and shared savings, while 12% receive payments from full risk. - This leaves a significant portion, over 50%, still relying on traditional Fee-For-Service models. Healthcare Providers Seek Guidance in VBC Transition The survey also highlights the increasing demand for
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Strive Health, Medical Mutual Partner to Bring Value-Based Kidney Care to Ohioans

by Fred Pennic 02/20/2024 Leave a Comment

Strive Health, Medical Mutual Partner to Bring Value-Based Kidney Care to Ohioans

What You Should Know: - Strive Health, the national leader in value-based kidney care, and Medical Mutual, one of the largest Ohio-based health insurance companies, announced a new value-based kidney care partnership. - The strategic collaboration aims to deliver value-based kidney care to eligible members with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) across all lines of business, including Medicare Advantage, individual, and commercial group health
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Demystifying VBC Contracting: Key Considerations for Quality & Data Success

by Elissa Toder, MBA, VP of Quality Improvement Strategy & Solutions at Reveleer 02/08/2024 Leave a Comment

Demystifying VBC Contracting: Key Considerations for Quality & Data Success

In the ongoing transition to value-based care (VBC), provider contracting poses challenges for health plans and providers. In my past role as the VP of Quality at a large health plan, I was part of the team that reviewed provider contracts that included risk around quality. Adding my role to the review process reduced the frustration of the Network and Quality teams because I could identify the reporting requirements that the health plan couldn't meet and create alignment with measure
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Medical Home Network Expands Value-Based Care Reach with 64 FQHCs in New ACOs

by Jasmine Pennic 02/06/2024 Leave a Comment

Medical Home Network Expands Value-Based Care Reach with 64 FQHCs in New ACOs

What You Should Know: - Medical Home Network (MHN), a leader in transforming care in the safety net, announced today its partnership with 64 federally qualified health centers (FQHCs) across seven states. These FQHCs will participate in two key CMS value-based care programs: ACO REACH and MSSP (Medicare Shared Savings Program). - This expansion comes on the heels of an impressive achievement by existing MHN partners: $10.1M in gross savings and a perfect quality score in the 2022
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