The Center for Medicare & Medicaid Innovation (CMMI) has launched more than 50 alternative payment and care delivery model tests, with 33 models now or still operational, according to CMMI’s sixth report to Congress on its progress. These...
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Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have...
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Implementing and pursuing innovation in digital health and healthcare IT should be a priority for all U.S. healthcare providers and payers — especially as the lessons and response to the Covid-19 pandemic become permanently part of our everyday...
More InfoLow reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital...
More InfoValue-based payment is severely lacking as a percentage of total medical revenue across practices as providers face scheduling and billing challenges. The transition to value-based payment is moving at a snail’s pace despite healthcare’s long...
More InfoThe CY23 End-Stage Renal Disease (ESRD) Prospective Payment System Proposed Rule would increase Medicare reimbursement rates, among other policy changes. CMS recently proposed the Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective...
More InfoMedicare Advantage beneficiaries who received care under value-based payment models, including two-sided risk models, saw lower acute care use than beneficiaries under a fee-for-service model. Medicare Advantage beneficiaries whose primary care...
More InfoNew data from LAN shows modest progress with value-based reimbursement adoption in 2019 and 2020. But some programs, like Medicare Advantage, are moving to financial risk faster than others. Most healthcare payments made in 2020 were tied in some...
More InfoThe volume of Medicare beneficiaries has been slowing growing while the distribution of Medicare plans is quickly changing. Medicare provides federal healthcare coverage for Americans 65 or older, or anyone with end-stage renal disease...
More InfoOver half of health systems also said they plan to advance risk-based payments or some form of capitation in commercial lines of business. The executive survey conducted by the Healthcare Financial Management Association (HFMA) for the Guidehouse...
More InfoProvider-sponsored health plans can be naturally aligned with value-based care goals while also being attuned to providers’ needs. Providence Health Assurance’s Medicare Advantage provider-sponsored health plan received a five-star rating through...
More InfoOrganizations that do strong vendor relationships, invest in the organization, and are willing to take on commercial risk will be poised to take on downside risk financial contracts. Through working with population health management vendors, KLAS...
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