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Focus on Value-Based Care

HIMSS Media in June will interview experts about how they take on risk, prove outcomes and become more profitable in a post-capitated world.

The world of value-based care and payment for outcomes is closer than you think. Leaving fee-for-service behind and transitioning to value-based payments is reshaping the industry. From solo practitioners and hospital clinicians to health system finance and operations executives, the implications are inevitable.

That's exactly why leaders need a strategy.

During June, Healthcare Finance News will interview the experts about how they take on, stratify and manage risk, prove outcomes and ultimately become more profitable in a post-capitated world.

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Strategic framework is needed to evaluate whether health system partnerships are achieving goals

System leaders should regularly evaluate existing and new partnerships to ensure that they're meeting their desired outcomes.

Value-based care requires payer and provider collaboration

Employers are demanding better value in their plans and consumers expect that Amazon experience.

Change Healthcare rolls out new AI tech to help reduce denials

The tool can help health systems optimize submissions and better predict potential issues with claims, the company says, giving recommendations to help mitigate denials before they're submitted.

Innovaccer research shows how AI could improve cost of care models

A new study from the company explores the ways its algorithms can be put to work improving risk scoring and stratification and enhance value-based care initiatives.

EHRA to CMS on IPPS rules: focus 'high-value' measures, keep 90-day reporting

The HIMSS EHR Association tells the Centers for Medicare & Medicaid Services that the Promoting Interoperability Program needs consistency and specificity in its clinical requirements.

Oak Street Health invests only in value-based care

While the nation is going digital for services, healthcare needs a physical presence and Amazon is also expanding that strategy.

Machine learning is only as good as the value it brings

The new model aims to provide high-quality, coordinated oncology care at the same or lower cost to Medicare.

Community Oncology Alliance proposes value-based alternative payment model to reduce costs

The new model aims to provide high-quality, coordinated oncology care at the same or lower cost to Medicare.

Healthcare leaders need the right technology philosophy, to succeed in transitioning to value-based care

The appropriate use of technology will play an important role in the switch from volume to value, but it helps to have the right approach.

Analytics could prevent unnecessary helicopter rides for hospitals

Researchers at Case Western Reserve University are developing an analytics platform to help determine the medical necessity of using helicopters for emergency transport.

The importance of data in value-based care, and how to maximize it

EHRs can be an inadequate source for data-driven insights, and so better strategies are needed to get a handle on value-based care.

American Medical Association urges creation of APMs focused on at-risk populations

AMA is advocating for appropriate risk adjustment of performance results based on clinical and social determinants to avoid penalizing physicians.

Humana to integrate IntelligentRx into Epic's e-prescribing workflow

Humana says it is the first national insurer to collaborate with Epic to bring together patients, providers, and the insurer in a value-based model.

Q&A with Andy Slavitt on investing in underserved populations

"Medicaid is filled with success stories, but not the capital," Slavitt says.

28 health systems in Medicaid Transformation Project look to lower costs and improve outcomes in behavioral health

The national project is aimed at developing financially sustainable solutions to improve the health of underserved individuals and save money.

CMS seeks input on Patients over Paperwork initiative to reduce red tape and to lower costs

Regulatory reform is estimated to save the healthcare system an estimated 40 million hours and $5.7 billion from 2019 through 2021.

Consumers and physicians say convenience must be the foundation of any health strategy

Consumers are also interested in technologies that will help them manage their health and engage with physicians.

Health systems diversify to grow their business

The strategy can carry credit risks, because when hospitals stray from their core competencies, they may strain their financial health, Moody's says.

Healthcare spending accelerated during the first quarter, while price growth climbed slightly

With March, the streak of 17 consecutive months in which year-over-year growth in health spending was less than GDP growth has come to an end.

Vast majority of patients would show more loyalty to providers if they had access to holistic health and wellbeing support

Most adults say it's important their provider offer programs and resources, but they don't want it through patient portals.

Screenings for social determinants of health need to be tailored to clinics, BU finds

The average health center only screened for 8 of the 16 domains in the pilot's standardized screening.

Quality standards framework can improve both clinical and financial performance in healthcare

A consistent framework is needed to ensure healthcare quality workforces are efficient, effective, and delivering on ROI.

With medical groups employing more physicians, a leader with the right skill set is paramount

Any medical group requires a strong leader, and the most important qualities to look for are dependent on the needs of the organization.

Certain hospitals turn away ambulances when the patient is more likely to be poor, study shows

Private hospitals are more likely to enact an ambulance diversion if a nearby public hospital is already turning away ambulances.

Machine learning overtakes humans when it comes to predicting death or heart attack

Machine learning advances go above and beyond what has presently been achieved in medicine, the findings showed.

Mental health patients insured by marketplace health plan less likely to receive a medical appointment

Success was highest for those with employer coverage while marketplace enrollees were statistically more likely to run into trouble.

Health plan customer satisfaction challenged by new era of empowered healthcare consumers

A big challenge for health plans is addressing member expectations based on their experiences in other industries.