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 Payment Models
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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The SDOH Reality Check: Coding, Claims and Value-Based Care
While the need to address social determinants of health (SDOH) is definitely not new, 2023 marks the first year SDOH is codified into national and statewide value-based payment program mandates. These mandates are designed to hold Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs) accountable. While the rollout of SDOH code sets across our healthcare ecosystem is one phase, alone it’s not enough. The next phases are even more critical: codes must be collected, used,
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Edifecs and 3M Partner on Integrated Value-Based Payment Solution
What You Should Know:
- 3M Health Information Systems and Edifecs (a global health IT solutions provider) announced a collaboration and new unique solution for providers and payers that will accelerate the adoption of value-based payment (VBP) models.
- A new, combined solution that will overcome barriers that have previously prevented rapid adoption of VBP models. This advanced approach will allow payers and providers to quantify the value of preventing negative events and allocate
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Lyfegen Raises $8M for Value-Based Contracting for High-Cost Drugs
What You Should Know:
- Lyfegen, a global health tech SaaS company driving the world’s transition from volume to value-based healthcare for high-cost drugs raises $8M in Series A financing round led by aMoon, with additional participation from APEX Ventures and others.
- Lyfegen’s value-based contracting software is used by healthcare payers and leading pharma companies, including Novartis, Roche, MSD, Bristol Myers Squibb (BMS) and Johnson & Johnson.
Value-Based
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Report: The State and Science of Value-Based Care
What You Should Know:
- Providers believe 96% of payment is now value-based in some capacity, and 58% believe their EHR vendor won’t be able to support the data strategies required to thrive under value-based care, according to a new study conducted by Morning Consult and Innovaccer.
- The 37-page national research study uncovers key IT infrastructure issues healthcare leaders said are impeding or essential for progress towards accelerating their transformation to value-based
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Canvas Medical Raises $24M for EMR & Payments Platform
What You Should Know:
- Canvas Medical, the EMR that enables clinicians and developers to power the future of care delivery, has raised $24M in Series B funding led by M13 with participation from Haystack and previous investors Inspired Capital, IA Ventures, Upfront Ventures, and Irongrey.
- In addition to this funding, Canvas has achieved federal certification through the Office of the National Coordinator for Health Information Technology (ONC).
A Full-Stack Ambulatory EMR and
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6 Success Strategies as CMS Drives More Accountable Care by 2030
For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Working to develop, test and evaluate new payment and delivery models in Medicare, Medicaid and the Children’s Health Insurance Program, CMMI has taken aim at improving the provider experience, generating better patient outcomes and reducing the overall cost of care.
Recently, CMMI stated that by 2030 every Medicare
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Report: Advancing Tech-Enabled Health & Home Care
What You Should Know:
The Milken Institute Center for the Future of Aging today released a report to identify actionable recommendations to better integrate health and home care through technology. These recommendations were gathered from a convening of stakeholders representing health care, technology, government and policy, research and academia, philanthropy, advocacy, and community-based organizations.
Report Background
While the COVID-19 pandemic heightened the focus on
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