A Decade of Value-Based Payment: Lessons Learned And Implications For The Center For Medicare And Medicaid Innovation, Part 1

June 9, 2021Garrett SchmittLibraryNo CommentsACOs, APMs, CMS, Cost Reduction, COVID-19, Fee for service, health spending, organization of care, payment, payment models, value-based payment, value-based purchasing, vbc

Over the past decade, adoption of value-based payment (VBP) models has increased substantially. The Center for Medicare and Medicaid Innovation’s has launched multiple new models since its authorization, commercial payers have structured almost one-third of their payments as alternative payment models (APMs), and state Medicaid programs have increasingly included payment reforms in their waivers and…

Why should payers and employers care about community care networks?

June 9, 2021Garrett SchmittLibraryNo CommentsCBOs, CCNs, community care networks, DEI, holistic, Payers, precision health, Precision Medicine, SDOH, value-based benefits administration, VBBA, vbc

There’s a growing awareness among employers, community advocates, and the public health sector that issues of diversity, equity, and inclusion (DEI) must be addressed in the healthcare ecosystem if we are to implement genuine value-based care (VBC). Unlike traditional fee-for-service healthcare, VBC emphasizes keeping people well over “sick care.” As a holistic approach to healthcare,…

Bill aims to fix glitch that penalizes rural ACOs even if they generate savings

June 9, 2021Garrett SchmittLibraryNo CommentsAccountable Care in Rural America Act, CMS, MSSP, Rural, rural ACOs, rural providers

New bipartisan legislation aims to fix a glitch that can penalize rural accountable care organizations that reduce costs. The legislation, introduced Tuesday, would fix a flaw that requires all ACOs to measure their performance against themselves, which lawmakers say can disproportionately impact rural providers. The bill comes as ACO advocates have been worried about a…

Building a Value-Based Care Infrastructure in Europe: The Health Outcomes Observatory

June 9, 2021Garrett SchmittLibraryNo CommentsEurope, European Union, Health Outcomes Observatory, Innovative Medicines Iniative, value-based care, vbc

Sustainable health care systems should be focused on outcomes instead of reimbursing for the services provided. Critical levers for accelerating this are patient engagement and a more comprehensive, standardized collection of patient outcomes. Also, more expertise is required on how these data can best be incorporated into the care process. The Innovative Medicines Initiative project,…

Leveraging innovative health technology solutions to combat social determinants of health

June 9, 2021Garrett SchmittLibraryNo CommentsChronic Care Management, COVID-19, Data, EMRs, health disparities, health technology, information sharing, remote patient monitoring, SDOH, technology, Telehealth

Nearly every chronic health condition has an increased prevalence with declining income; in fact, the life expectancy of the wealthiest American is ten to fifteen years longer than that of the poorest. Health disparities negatively affect people who experience larger obstacles to achieving optimal health due to lack of access to care. Healthcare systems face…

UN calls for private sector to play its part in beating health inequality

June 9, 2021Garrett SchmittLibraryNo CommentsCOVID-19, Data, health inequality, patient access, SDOH, UN

Dr Ahmed El Saeed, Focal Area Lead at the United Nations Global Pulse Finland, Executive Office of the UN Secretary-General, said: “International development is everybody’s business. You can do business and do good, and this is a message to the private sector, there is a very important role for the private sector to play in…

The Crucial Role of SDOH Data in Value-Based Care

June 8, 2021Garrett SchmittLibraryNo CommentsData, SDOH, value-based care, vbc

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…

4 SDOH Driving Health Disparities in Patient Portal Use

June 8, 2021Garrett SchmittLibraryNo Commentshealth IT use, patient portals, SDOH, technology

As patient portal use and access become more commonplace in healthcare, it would be prudent for health IT leaders and clinicians alike to understand the health disparities that can also emerge with patient portal use. The latest data shows that patient portal offerings are near universal. 2019 data from the Office of the National Coordinator…

Softer Alignment of Medicare ACOs May Still Lead to Higher Prices for Office Visits

June 7, 2021Garrett SchmittLibraryNo CommentsACOs, Medicare ACOs, MSSP

A softer form of health care consolidation, where independent primary care practices align in certain Medicare accountable care organizations (ACOs) to negotiate with payers, may lead to higher prices, but not to an overwhelming extent, according to a new study published Monday in Health Affairs. Researchers focused their work on independent practices joining ACOs led by…

Building a social determinants of health strategy: data is the key

June 7, 2021Garrett SchmittLibraryNo CommentsData, managed-care plans, SDOH

For managed-care plans focused on improving population health and reducing overall costs, the goal has to be on prevention, not just treatment. One increasingly popular strategy is targeting members based on social determinants of health (SDOH), which accounted for around $2.5 billion in spending between 2017 and 2019, according to a 2020 study. But how…