As the coronavirus pandemic continues to upend health care in the U.S., pressure has mounted on CMS to adjust its efforts to drive providers to adopt risk. In response, at the end of last week CMS announced a carve-out of COVID-19 patient expenses from certain reporting requirements. In this round, ACOs were on the receiving […]
Stretched to the Limit by COVID-19, Will Providers Get Relief from Medicare Value-Based Programs?
This article originally appeared in the April 2020 edition of Accountable Care News [PDF download]. COVID-19 continues its inexorable, exponential spread here in the U.S. Hospitals in New York City, now accounting for more than 7 percent of confirmed cases worldwide, have less than a quarter of the critical equipment and supplies needed to serve […]
Value-Based Care Defined: Know the Vocabulary of Health Care Reform
Today, as we confront a viral threat that is challenging our health system, its capacity, and how care is financed, it seems appropriate to review some fundamentals. Health care reform has been speeding down a particular track, changing how health care is covered, paid, delivered, and organized. These reforms may seem to be about health […]
ACO Path to Viability: Direct Contracting May Be the Opportunity
What if your best route to viability was the high-risk path you feared the most, because that failure might destroy you? That’s the question Accountable Care Organizations (ACOs) have been asking this week—whether to participate in Medicare’s new Direct Contracting (DC) initiative. With a shift in payments from Fee for Service (paid per-provider service), to […]
How AI Can Engage Consumers to Reduce Disease Risk: The Case of Atrial Fibrillation
In our last article, we assessed how AI could be used to achieve clinical success for individual conditions, and to apply the technology to broad cost reduction efforts and population health interventions. But here’s the real test: Can we effectively apply AI technology to help patients better engage in lifestyle risk reduction—particularly for specific conditions […]
Can Artificial Intelligence and Machine Learning Reduce Health Care Costs?
All the experts’ 2020 health care technology predictions have one trend in common—more Artificial Intelligence. AI and its subset Machine Learning are tagged as the winning ticket to advances not only in clinical medicine and research, but also in administration and management. The hype promotes so many potential applications for AI that it begs for […]
Can Hospitals Still Lead Health Care Under Risk?
As the millennium’s third decade begins, Risk has taken hold as THE strategy for tackling health care costs. Virtually overnight (in health care years) the industry has moved—albeit not uniformly—to accept Risk. This transition is already beginning to impact hospitals and hospital-based systems, and raises serious questions about the viability of their role as the […]
Can Consumers Be the Answer to Health Care Cost Control?
In the intense ramp-up to accepting Value-Based Health Care payment models that include financial risk, providers have implemented an array of technologies and programs to improve cost performance. They are in a race against time. Capitation is re-emerging as a dominant payment type under Medicare Value-Based Primary Care Models and commercial contracts. Alternative Payment Models […]
Get the eBook: Turn Health Care Chaos into Value – Give Voice to Providers and Consumers
Are we on a real path to reducing health care costs and improving our citizens’ health? Those were stated goals in the early 2000s that developed into what is now called Value-Based Health Care (VBHC). VBHC has come to mean a major reform effort to slow the pace of cost increases through changes in incentives […]
Bottom Line: Can Consumers Survive Value-Based Health Care?
As 2019 nears its close, health care has reached a crossroads. Value-Based Health Care was intended to clarify consumer choices and motivate providers to offer high value services that improved outcomes, as well as to improve patient access to those services. But has that goal been realized? Has anything really changed? Or are health care […]