Model Targets Hundreds of Millions in Medicare ED Spending
Feb. 18—Heralded as part of a shift in care to lower-cost locations, a new Medicare model coming early next year will incentivize paramedics to find alternative treatment sites to emergency departments (EDs).
Data Sharing Tips for Value-Based Payment Arrangements
Value-based contracts require that provider organizations and health plans share data and information that they may not have shared historically. Details about that data-sharing must be established in contracts.
Feb 4-8: CMS Developing ESRD, Cancer Models
Jan. 31—Federal changes coming in 2019 to healthcare payment models slowly emerged this week, as federal healthcare leaders prepare to address a national policy meeting in Washington D.C.
Medicare Expands Value Pay in MA and Part D Plans
Jan. 21—Medicare is expanding its value-based insurance design (VBID) model and creating a new drug plan model.
Value-Based Payment Can Reduce Need for Preauthorizations
BlueCross BlueShield of Western New York has removed prior authorization requirements for more than 500 therapies, services, and procedures in conjunction with its move to value-based payments for primary care providers.
Medicare Shared Savings Program 2019 Final Rule Summary
This document provides a comprehensive summary of December 2018 Medicare Shared Savings Program final rule, published by CMS.
Medicare Shared Savings Program 2019 Final Rule: HFMA Executive Summary
This document briefly highlights noteworthy details of the 2019 Medicare Shared Savings Program final rule, published by CMS.
Lessons from a BCBS Plan’s Plunge into Value-Based Payment
Nov. 26—Commercial insurers—and Blue Cross Blue Shield plans, in particular—have been shy about moving into value-based payment (VBP). But one southwestern insurer’s experience may help change that.
Not Just Smarter Payment, Better Health Care
Jeb Dunkelberger describes how Highmark Health uses its experience as an integrated care delivery and finance system to advance strategies that improve the value of health care.
What Healthcare Policies Will the Election Produce?
Nov. 9—A divided Congress may be a recipe for overall gridlock, but some healthcare policy watchers see hope for action in certain areas.