5-imperatives-for-value-based-care-technology
Alternative Payment Models (APM)Episodes of CareFuture of Health CareNew Script for APMsPerson-centered Health CareValue-Based Health Care
June 23, 2022

5 Imperatives for Your Value-Based Technology to Support APMs

After years spent transforming your health care technology, you may feel like you're almost done. But Value-Based Care Technology requires a different mindset. With reimbursement scaling to a tipping point for APM adoption, think "reboot" instead. Your health system or group has a long way to go if your aggregated and integrated data cannot support person-centric care and data-directed population health, quality, and health equity strategies. The Value-Based Care Technology game is no longer focused on implementing an EHR, or even population health. Those are basic ingredients that make it possible to do more. Now it's about bringing all the…
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Alternative Payment Models (APM)Consumers & PatientsFuture of Health CareNew Script for APMsValue-Based Health Care
June 8, 2022

Six Ways Competition Must Shape Your APM Strategy

Now that you've made the decision to start your path to Alternative Payment Models (APMs), what's the first thing you need to consider? Hint: APM revenue calculation does not top the list. Obviously, APM revenue generation vis-à-vis traditional Fee-for-Service is critical. But those calculations assume constancy of two essential “assets”—clinicians and patients. Your competition is working hard to grow these same resources for their own operations. The easiest place to get them from is your organization. If you are following the growth of practice acquisitions from investor-backed health care companies and MSOs, payer practice acquisitions and retail giant investments in…
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Alternative Payment Models (APM)Future of Health CareValue-Based Health Care
May 18, 2022

Wanted: Better Script for Health System and Medical Group Transition to APMs

Health care has been suffering for a while—just ask any participant, including patients. You will hear about burnout, pressures to perform, changes in the market, pressures of new technology, fiefdoms, consumerism, and to top it off, the buildup of competition between traditional health care enterprises and new corporate health care businesses. Then there’s the pandemic, which may be sidelined publicly but continues to ravage health and the business of health care. Value-Based Care and its sidekick, Alternative Payment Models (APMs), continue to pressure health care finances. Providers, who have played cat-and-mouse with APMs for a while now, are beginning to…
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Consumers & PatientsCost TransparencyFuture of Health Care
February 16, 2022

More Health Care Transparency Means Provider Conversations Need to Change

New federal laws and regulations focused on improving health care transparency are giving consumers significant access to essential health care information, particularly regarding costs. In a recent interview with Erika Grotto at HFMA, Roji CEO Terry Hush explains why that means the conversations that providers are having with their patients need to change. Listen to the podcast, and read the full transcript here. Read the blog post by Erika Grotto here. Founded in 2002, Roji Health Intelligence guides health care systems, providers and patients on the path to better health through Solutions that help providers improve their value and succeed in…
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ACOsConsumers & PatientsFuture of Health CareMedical Decision-MakingValue-Based Health Care
February 9, 2022

Seven Key Strategies for Health Systems and ACOs to Attract and Engage Consumers

Despite incredible work by health care workers during the pandemic, consumer and patient trust and belief in the health care system is dangerously low. Why is this a big problem now? Because as pressure to implement Value-Based Care initiatives is intensifying and creating more financial pressure on your already-slim margins, your health system or ACO must depend on patient-consumers to shore up your enterprise and revenues. Without building better consumer relationships, healthier consumers will seek alternatives and leave you with less revenues and sicker patients. In our previous post we delved into the reasons behind that breakdown in trust. Now…
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Consumers & PatientsFuture of Health CareValue-Based Health Care
January 24, 2022

Will Consumers Derail Your Value-Based Care Success?

Your health care organization may be on the tightrope of still coping with COVID-related illness and delivering essential patient care, amidst staffing and supply shortages. But in 2022, life is not poised to give health care a breather. Likewise, there is no slow-down to the expansion of Value-Based Care and payment models or development of further stages in 2022. This year, providers in traditional Medicare will rack up stiffer penalties if costs are higher than CMS algorithms calculate. More ACO providers will progress along the path to Risk, and more will participate in alternative payment models (APMs). This will be…
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ACOsAlternative Payment Models (APM)Future of Health CareRiskValue-Based Health Care
January 6, 2022

Five Predictions for the Fate of Value-Based Health Care in 2022

Only a few days into 2022, it seems obvious that many predicted “trends to watch” floated in late 2021 won’t, in fact, be what will matter most in this critical year for health care. Not that these issues aren’t important, but they are not new (if you’ve been paying attention and, hopefully, planning your strategies). The major predictions are underwhelming: Telemedicine and other types of virtual care will continue to advance. Digitization of health care for consumers will disrupt traditional channels of information and engagement. There will be more collaborations and blurred lines between payers and providers, and even more…
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ACOsFuture of Health CareRiskValue-Based Health Care
November 17, 2021

Supercharge Your Way to Value-Based Care

Whether you are an ACO, a health system considering value-based payment, or a medical group weighing your options for Value-Based Care, Roji’s new eBook, Supercharge your ACO for Top Value, has the strategies you need to reduce the cost of care and get clinician backing for innovation. The health care market’s reconfigured landscape puts ACOs—and health care organizations still in a Fee-for-Service contracting circuit—in danger of losing their ability to capture the savings from more effective and efficient health care driven by data, strong physician buy-in, and direct-to-consumer marketing. Medicare Advantage and equity-backed medical groups are competing with traditional providers…
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ACOsConsumers & PatientsFuture of Health CareValue-Based Health Care
August 24, 2021

Cost Savings Aren’t the Only Objective for ACOs: Growth Matters, Too

Keeping within expenditure limits is a top priority for most ACOs for Medicare. That makes sense. Savings are the main distinguishing feature of an ACO arrangement, as opposed to straight Fee-for-Service reimbursement. ACOs that accept downside risk can’t afford to exceed the expenditure target. It’s in their best interest to create initiatives to cut costs and control expenses—especially for services outside the ACO, such as post-acute care. But a cost strategy only focused on trimming expenses will likely fail the ACO in the long run. Why? Medicare ACOs face an annually decreasing expenditure limit that mandates them to lower costs…
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ACOsFuture of Health CareRiskValue-Based Health Care
August 19, 2021

New ACO Playbook: Three Ultimate ACO Strategies to Keep Physician Practices Onboard

ACOs have zealously protected their favored status under Medicare Value-Based payment models, ensuring enough time for organizations to feel comfortable with financial risk and make investments in infrastructure. But if your own ACO is losing physicians to new equity-financed networks or to hospitals consolidating practices, more time does not help you. Primary care physicians are being picked off by your competition, and their patients go with them. Private equity firms and venture capital-funded groups have gained significant ground in acquiring physician practices, with mergers and acquisitions hitting record highs in 2019 and 2020, and accelerating in 2021. Equity firms and…
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