Two Sides to the APM Coin: Why APMs Work for Some and Not For Others
Integrated delivery systems are at a disadvantage under alternative payment models (APMs), which has hindered the success of these models; redesigning how shared savings are distributed to address this disadvantage may help promote the success of APMs.
Calling Into Question the Nation’s Commitment to Value-Based Health Care
There is widespread agreement that the goal of transitioning the nation’s healthcare system to value-based payment is important, but there remain many impediments to accomplishing such a transition.
Rethinking Health Care’s Triple Aim
Achieving health care’s Triple Aim has proved elusive, but it may be yet be achievable through a process of engaging rising-risk patients in their own care through daily self-reporting.
Targeted Care Integration Can Help Drive Success Under Risk Contracts
Providers can avoid many of the missed opportunities associated with risk contracts by carefully reviewing the targeted patient population, narrowing the number of performance metrics, and selecting the right clinicians to participate.
Value-Based Payment and Commercial Healthcare Insurers: Getting Paid for Doing What’s Right
Healthcare providers may find that their managed care contracts include provisions that may have been beneficial under a fee-for-service payment model but are highly unfavorable under a value-based payment.
Highmark Sees the ‘Value’ in VBID for MA Plans
Ellen Galardy of Highmark, Inc. describes the health plan's participation in a value-based insurance design pilot that seeks to improve the care of chronic conditions.
Is Focus of Value Based Care Moving From Hospitals to Physicians
Recent changes to bundled payment models are the among the developments that suggest the Trump administration may be seeking to shift the focus of value-based care from hospitals to physicians.
The Collateral Impacts of MIPS
Tom S. Lee describes the long-term effects a MIPS score can have on providers.
Closing Health Care’s Value Gap
To ensure current and future success, healthcare providers must take deliberate action to bridge the gap between volume-based payment and value-based payment.
Taking Control of Pay-For-Performance Contracts
To ensure their organizations perform effectively under risk contracts, healthcare finance leaders should implement a work plan to manage the contracts.