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News Clips
American Enterprise Institute (2/10) Policy Options to Address Consolidation in Healthcare Provider Markets – This report builds on a convening held in Washington, DC in May 2024 that brought together 17 health policy experts to consider the status of consolidation among health care providers, the challenges it poses to health care, and the legal, regulatory, and policy frameworks that can influence its impact. While any policy reforms are certain to face resistance and court challenges prior to implementation, the Working Group report emphasizes the importance of taking action to foster a more competitive healthcare marketplace that better serves the public interest.
Forbes (2/11) Medicare Is Failing Patients: A New Bill Can Help Fix That – Physician reimbursement under Medicare has declined by 33 percent from 2001 to 2025, according to the American Medical Association. Over the same period, Medicare payments to hospitals surged by nearly 60 percent while hospital executive salary has also skyrocketed 93 percent over a decade. How can private practice physicians stay in business to continue providing care for patients? Physicians are bracing for yet another 6% reduction in take-home pay this year. A recently proposed bill, the Medicare Patient Access and Practice Stabilization Act, co-sponsored by Reps. Murphy (R-NC), Rep. Panetta (D-CA) and eight other House members, seeks to address this issue. The bill aims to reverse the Medicare cut to physician pay and, more importantly, align physician reimbursement with inflation, ensuring continued access to care for Medicare patients.
American Medical Association (2/12) How the CPT code set can help speed up value-based care adoption – The move toward value-based care involves “a reimagining of the traditional definition of health care delivery” with the aim of supporting better outcomes at lower costs, according to a report from the AMA and consultants Manatt Health. The report notes that a decade of performance measures has shown that Medicare Accountable Care Organizations (ACOs) deliver quality care while saving Medicare money. But, despite these metrics, comprehensive adoption of value-based care has been slow, with almost 90% of all U.S. health care physician payments in 2022 having at least a portion tied to a fee-for-service architecture.
Health Affairs (2/12) Addressing The Burden Of Spine-Related Disorders Through Integrated Value-Based Care – A shift from fee-for-service care to value-based models would correct the perverse incentives that currently undermine optimal treatment of spine-related conditions. Such a transition could prioritize outcomes, reduce the overuse of low-value services, and incentivize the integration of multidisciplinary and evidence-based approaches. To date there is limited funding from government agencies for this effort and a lack of industry initiatives to explore what a value-based, population health-focused framework for treating spine-related disorders would entail. However, there are signs of movement in this direction. For example, the Innovation Center recently rolled out a strategy to support person-centered, value-based specialty care to begin addressing the issues with fee-for-service care. Nevertheless, more work is needed. In this article, we outline the pressing need to build upon this and other existing VBC models for a range of disease conditions to directly target the delivery of evidenced-based spine care within a value setting.
Healthcare Innovation (2/13) A Provider Leader Looks at California’s Multi-Plan Breakthrough Around Value-Based Care – A variety of different initiatives have been created and implemented across the U.S. around value-based contracting; they are extremely diverse, with every single one encompassing different elements. But an initiative that has just launched in California offers a real first: three major health plans operating in the Golden State have come together with a major national purchaser group and a statewide association representing provider interests, to pursue integrated care delivery and care management work with physicians in group practices across the state. The demonstration project prioritized recruitment of small independent practices and will address long-standing disparities in primary care payment, promote health equity, and improve population health in California. It is designed to scale across the state and beyond.
Med City News (2/14) Atria Health Launches National Partnership Model to Keep Cardiology Practices Independent – This week, Atria Health launched an alternative model — one that focuses on maintaining independence. The Philadelphia-based company scaled its autonomy-focused partnership model to be available nationwide. Atria doesn’t buy and then subsequently own practices. It provides capital, expertise and technology to help cardiologists build independent, physician-led practices. “Atria Health forms a long-term partnership with a physician-owned and -led practice. They maintain their business and clinical autonomy. These long-term relationships allow us to invest capital, capabilities and capacity to support the practice in their vision for growth and patient service,” stated CEO Matt Eakins. He said Atria is focused on creating new, value-based service lines together with its partners.
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