News Clips
Business Insider: (12/22) - The convergence of COVID-19 and the CMS interoperability rule has accelerated interoperability in health care, as evidenced by major insurance companies investing in health data-sharing startups like Centene’s funding of Diameter Health. Such interoperability initiatives are key to a widespread shift to value-based care and can contribute to a more sustainable VBC model.
Modern Healthcare: (12/21) - Innovative value-based payment agreements are key to addressing unmet health needs and moving toward a health care system centered on improved patient outcomes and reduced medical spending. In this article, Boehringer Ingelheim outlines its views on value-based agreements and how such agreements play an important role in addressing uncertainty, tracking real-world outcomes, building on foundational clinical safety and efficacy trials to assess real-world value, and pushing the pharmaceutical industry to invest more to ensure products address clinical and societal needs.
Healio: (12/21) - New data revealed that hospitals enrolled in the Medicare Bundled Payments for Care Improvement (BPCI) program saved 2 percent for each major hip or knee replacement compared with hospitals that were not enrolled in the program. To examine this further, a study published in the Annals of Internal Medicine examined whether hospitals and clinicians responded to incentives under bundled payments by redesigning care for all patients.
Delaware.gov: (12/21) - A new report, titled “Delaware Health Care Affordability Standards: An Integrated Approach to Improve Access, Quality, and Value,” includes the State of Delaware’s plans to strengthen primary care in the state by doubling primary care spending in the commercial market by 2025.
Fierce Healthcare: (12/18) - NAACOS wrote a letter to CMMI calling for a halt to the new Geographic Direct Contracting model, citing concerns for its potential to add confusion and complexity for beneficiaries compelled to participate in the model. NAACOS offered several policy recommendations to CMMI on the matter, including fixing existing model overlap issues rather than creating a new layer of complexity with this model.
Modern Healthcare: (12/18) - Digital health resources have been a valuable bridge connecting providers and patients during the COVID-19 pandemic. Investing in virtual care capabilities to improve patient access to care could help practices to progress through the continuum of value-based care and encourage success in risk-based contracts.
JAMA Network: (12/18) - A new analysis published in JAMA looked at both the problems and successes observed with the transition to value-based payments (VBP), outlining how early efforts at outpatient VBP, especially with MIPS, have not met their goals. The article outlines possible changes that can be made to make meaningful improvements to clinician payment in Medicare by building on the success of MSSP, MA, and the Alternative Quality Contract to replace the current system.
Healthcare IT News: (12/17) - A recent study by Medical Care analyzed primary care exam lengths using electronic health record (EHR) time stamps. The study found that the average exam time lasted 1.2 minutes longer than scheduled, suggesting inefficiencies with scheduling logistics and within the EHR itself.
Fierce Healthcare: (12/17) - The Sequoia Project launched an initiative to help providers, health IT developers, and health information exchanges get into compliance with final rules around interoperability and information blocking. The Interoperability Matters initiative includes three community subgroups to reflect issues facing stakeholders and other communities affected by these rules to help them address operational issues and best practices.
Fierce Healthcare: (12/16) - A new analysis from PwC found that hospitals and health systems that have health plans or value-based care arrangements will be better positioned to cushion financial fallout from COVID-19 moving into 2021. The analysis reveals that providers will likely face uneven recovery, and that systems that heavily invested in value-based arrangements have fared better.
Health Payer Intelligence: (12/16) - While the transition to value-based care has been a slow process for some health payers, plans such as Blue Cross and Blue Shield of North Carolina (Blue Cross NC) have used its programs to advance value-based arrangements. Blue Cross NC launched its Blue Premier program in 2019 and has achieved 52 percent membership in value-based care arrangements as of mid-December 2020. The health plan pointed to its partnerships with providers that enabled the payer to make this rapid shift.
Revcycle Intelligence: (12/16) - Hundreds of medical organizations and lawmakers are pushing Congress to stop rate reductions to the Medicare Physician Fee Schedule that are set to begin January 1, 2021. While payment rates increased for many primary care services, over one million health care providers are being faced with payment cuts as high as 10 percent due to budget neutrality requirements in the rule. As several providers have been working on the frontlines of the pandemic, these groups pushed for Congress to #StopTheCuts as part of the year-end legislative package to support providers.
Health Care Payment Learning & Action Network: (12/16) - HCP LAN released the LAN Healthcare Resiliency Framework, describing key actions that payers, providers, and multi-stakeholder groups can take in the short-and long-term to promote more resilient and effective APMs.
Patient Engagement HIT: (12/15) - Steward Medical Group was able to meet patient needs during the pandemic by having a targeted telehealth and patient care access plan. This article outlines the experience of Stephany Godfrey, DO, a family physician with Steward Medical Group who practices in Boston. Godfrey says the actions taken by her practice to have such mechanisms in place allowed her to feel more prepared in addressing the current wave of COVID-19 cases.
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