Payment Models

Marcus Whitney: 3 healthcare innovation trends that leaders should keep an eye on

The workforce shortage, the behavioral health movement and value-based care are areas with the most momentum among early-stage investors.

Marcus Whitney March 30, 2022

Operationalizing value-based primary care: lessons from the field

The primary care physician’s office has a pivotal role to play in efforts of hospitals, payers and other healthcare stakeholders to transition healthcare payment to arrangements that reward providers for the value of the care they provide. However, to successfully execute a value-based primary care model, organizations should be mindful of the all-too-common pitfalls that they may encounter along the way.

Matthew Bates March 25, 2022

CMS’s overhaul of the Direct Contracting program draws praise from supporters of value-based payment

Value-based payment advocates see reason for optimism in CMS’s recent decision on the future of its Direct Contracting model.

Nick Hut March 4, 2022

Medicare’s much-hyped Direct Contracting model faces an uncertain future

Medicare’s Direct Contracting model, touted as representing the evolution of alternative payment models, could be shelved less than a year after getting started.

Nick Hut February 16, 2022

Small study finds health systems lagging in providing value-based payment incentives to physicians

Despite the increasing proliferation of alternative payment models, a new study finds that health systems generally don’t give physicians financial incentives to improve the value of care delivery.

Nick Hut February 14, 2022

Senate panel discusses ways to address Medicare financing — and the consequences of not acting

Medicare Part D and Medicare Advantage could be prime targets as Congress seeks to shore up the Hospital Insurance Trust Fund before it becomes insolvent in 2026 as projected.

Nick Hut February 9, 2022

Healthcare News of Note: McKinsey analyzes a range of scenarios based on the infectiousness, immune evasion and severity of disease linked to the omicron variant

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: An in-depth analysis looked at what the U.S. can expect with the onslaught of the omicron variant, CMS rescinded a drug pricing model, and total healthcare utilization in 2020 dipped below 2019 levels.

Deborah Filipek January 28, 2022

How to create an employer-friendly healthcare center of excellence

Increasing health expenditures and the pressures of the recent pandemic have contributed to the development of a new type of center of excellence (COE), called the future-state COE, which is designed to better address the needs of large employers. This COE model incorporates value-based contracting and a strong incentive design into a service-line strategy to create employee health programs that benefit employers, patients and providers alike.

Kathy Najarian December 22, 2021

Healthcare industry leaders share ideas with CMMI for improving value-based payment models, with benchmarking a top concern

During a recent call with healthcare stakeholders, leaders with the Center for Medicare & Medicaid Innovation heard various ideas for improving value-based payment models.

Nick Hut December 4, 2021

Gail Wilensky: Physician payment and SDoH challenges loom large on nation’s path to value

Two primary obstacles stand in the way of the nation's ability to achieve cost-effective health and healthcare delivery: the slow transition to value-based payment by physicians and the need to address social determinants of health.

Gail R Wilensky, PhD November 30, 2021
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