Journey To Value: The State Of Value-Based Reimbursement In 2016

Journey to Value: The State of Value-Based Reimbursement in 2016

  • June 13, 2016

There's no turning back from value-based care and value-based reimbursement. Payers are 58% along the continuum to VBR, up from 48% in 2014. And Providers are now 50% down the road to value. That's according to a national study of 465 payers and hospitals conducted by ORC International and commissioned by Change Healthcare. Yet despite tremendous growth in capitation/global payments, pay for performance, and episode of care/bundled payments, many payers and providers still face obstacles in the transition to value-based care. See where healthcare stands in its journey to value and what it means for the industry in Journey to Value: The…

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The Top 10 Things Payers And Providers Can Do Today To Start Aligning With VBR Tomorrow

The Top 10 Things Payers and Providers Can Do Today to Start Aligning with VBR Tomorrow

  • March 11, 2015

CMS says VBR is now an imperative. What can you do to make the grade? By Carolyn J. Wukitch and Andrei Gonzales, M.D. The stakes have just been raised for payers and providers who are besieged by a rapidly changing market. In an announcement that reverberated throughout healthcare, HHS Secretary Sylvia M. Burwell introduced an initiative to make alternative payment the standard for 50% of Medicare reimbursement by 2018. That’s the first time HHS established goals for alternative payment models for Medicare. HHS wants 30% of fee-for-service payments to be tied to quality or value through ACOs, bundled payment, or…

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How We Can Make Healthcare Payment And Delivery Reform Work

How We Can Make Healthcare Payment and Delivery Reform Work

  • January 9, 2015

By David Nace, MD, Vice President and Medical Director, Change Healthcare Powerful incentives and inertia remain intact, limiting stakeholders’ willingness to experiment with the range of innovative reimbursement models that promise to make the effort and cost of reform worthwhile. The result: growing agreement that transition to a system that fosters experimentation with mixed reimbursement schemes is required to ease away from the existing FFS model and the entrenched processes and technologies that are already in place. It’s said that imminent execution concentrates the mind. It could also be said that the looming specter of draconian cuts to healthcare, and…

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Unlocking The Human Genome: New Challenges And Opportunities For Health Plans

Unlocking the Human Genome: New Challenges and Opportunities for Health Plans

  • October 28, 2013

Molecular Diagnostics (MDx), the next wave of innovation in healthcare technology, is arriving. Exciting, challenging, transformational, hopeful, complex, alarming, terrifying and expensive are all descriptions that are being used to describe the dawn of this new world. In an earlier post, I discussed the need to build a new diagnostic testing vocabulary that can be shared across payer, provider and lab stakeholders in order to improve collaboration and processing in diagnosis and claims. Following several generations of emerging technology involving digital imaging in the ‘80’s, 90’s, and ‘00’s, Molecular Diagnostics is now arriving with an entirely new view of our genetic…

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