Payment Models

Most healthcare organizations will embrace two-sided value-based care models in 2024, but many do not have clearly defined protocols to assess new opportunities

Read this article for various lessons and questions to consider before entering a value-based care contract.

HFMA January 30, 2024

The state of U.S. primary care: How new ways of thinking can spur meaningful improvement

As healthcare stakeholders consider ways to fortify the nation’s primary care system, industry leaders recommend emphasizing several strategies and components — and not waiting to act. “We’re close to midnight in many respects in thinking about how to urgently preserve and expand primary care in America,” Susan Dentzer, president and CEO of America’s Physician Groups…

Nick Hut January 16, 2024

In response to a congressional RFI, provider advocates give input on ways to bolster rural healthcare

Hospital and physician groups were among the respondents to a request by a key congressional committee for information on improving rural healthcare. In an RFI issued in September, the House Ways and Means Committee sought policy solutions for augmenting access to — and the quality of — healthcare in relatively remote areas. “The committee will…

Nick Hut October 19, 2023

Insights on population health management challenges through the eyes of C-suite leaders

Population health management is at a crossroads, and one key to ensuring its viability is to bolster stakeholder trust in the potential of value-based payment (VBP) models. That was a key takeaway from healthcare executives who took part in a September panel discussion at the 23rd annual Population Health Colloquium, hosted by the Jefferson College…

Nick Hut October 5, 2023

Children’s hospitals swim against the tide to improve the health of their patients and communities

As the nation’s pediatric hospitals strive to keep kids healthy, they face obstacles that reflect the difficulty of enacting structural changes in care delivery. Even pediatric hospitals that are eager to engage in value-based payment (VBP) models can have a hard time establishing the type of network that allows them to affect the holistic health…

Nick Hut August 22, 2023

The state of Medicare Advantage: As the program grows, healthcare stakeholders express concerns

As seen during a recent virtual conference, the accelerating expansion of Medicare Advantage (MA) has been accompanied by tension over growing pains such as regulatory issues. “I think MA was set up really well, but like anything else there’s sort of a moment where you have to look at the program and say: How do…

Nick Hut May 30, 2023

Harris Affinity Decision Support can help healthcare leaders identify meaningful areas for improvement

Improve your healthcare organization by leveraging advanced cost, performance, reimbursement and profitability data to inform and drive critical financial, operational and clinical decision-making.

HFMA May 1, 2023

Healthcare disruptor Glen Tullman says providers need more of a consumer-centric approach

One of the country’s most prominent healthcare entrepreneurs has a warning for legacy healthcare stakeholders. “Many of you in the audience are leading major health systems, and you’re the hub for healthcare today,” Glen Tullman said during a presentation at the HIMSS Global Health Conference and Exhibition, which took place the week of April 17…

Nick Hut April 25, 2023

State of Medicare: Some good news on program solvency still leaves questions and challenges

Medicare should remain solvent a little bit longer than previously anticipated, while a policy debate is ramping up over how to make the program sustainable for the long term. The 2023 annual report of the Medicare Boards of Trustees projects that the Hospital Insurance (HI) trust fund, which subsidizes Part A services, essentially will be…

Nick Hut April 17, 2023

Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern

An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…

Nick Hut March 31, 2023
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