Posts Tagged ‘value-based care’

Infographic: A State-by-State Value-Based Reimbursement Comparison

November 15th, 2017 by Melanie Matthews

There is a range of value-based reimbursement approaches and significant variation in the scope, leadership commitment, and resources devoted to the transition from fee-for-service to value-based reimbursement across the United States, according to a new infographic by Change Healthcare.

The infographic provides an aggregated look at which strategies states have adopted, whether they have chosen to set value-based payment (VBP) targets, the scope of their initiative (Medicaid or multi-payer), and the approximate year that the VBP initiative was implemented.

Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and MethodologyIf one trend has transformed the healthcare industry post-ACA more than any other, it is the market’s new business model rewarding value over volume.

Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and Methodology provides a framework for healthcare’s new value proposition, with advice from thought leaders steeped in the delivery and reimbursement of value-based care. Click here for more information.

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Infographic: Examining Medical Minds on Value-based Healthcare

May 12th, 2017 by Melanie Matthews

While political and economic environments may be changing, healthcare professionals agree that the journey to value-based healthcare will continue, according to a new infographic by 3M.

The infographic examines the move toward value-based care and healthcare professionals’ value-based healthcare perceptions.

11 Profitable Value-Based Reimbursement Models: Lessons from Early AdoptersCMS’s ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate. Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs). Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare’s per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours’ building of a business case for its multidisciplinary care team to the John C. Lincoln ACO’s deep dive into data analytics to identify and manage the care of high-risk, high-cost ‘VIP’ patients to ‘beat the benchmark’ to WellPoint’s engagement of specialists in care coordination.

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Infographic: The Cost of Low-Value Healthcare

October 28th, 2016 by Melanie Matthews

The use of low-value care and the associated cost is a significant concern in the U.S. healthcare system—the National Academy of Medicine (formerly the Institute of Medicine) indicated an estimated $765 billion of wasted healthcare expenditures in 2013. However, solutions to measure, identify, and eliminate low-value care are challenging and complex. To date, most efforts aimed at reducing low-value care have been limited to areas where there is a high degree of consensus that the care rendered is low value, according to a new infographic by the University of Michigan Center for Value-Based Insurance Design (VBID).

The infographic examines how VBID can address the issue of low-value care.

Positioning for Value-Based Reimbursement: Leveraging Care Management for Clinical and Financial OutcomesWhile others wait for the healthcare industry to complete its transition to value-based reimbursement, Bon Secours Medical Group has already aligned itself with payment reform, leveraging its care team and providers and automating workflows to enjoy immediate rewards from its patient-centered approach.

Positioning for Value-Based Reimbursement: Leveraging Care Management for Clinical and Financial Outcomes describes how this 600-provider medical group has primed its providers to employ a broad mix of team-based care, technology and retooled care delivery systems to maximize quality and clinical outcomes and reduce spend associated with its managed patients.

Click here for more information.

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Infographic: Value-Based Health Enhancement Program Shows Promise

April 11th, 2016 by Melanie Matthews

One state’s employee insurance program designed to improve health while reducing costs has successfully encouraged more use of screenings and preventive services, increased medication adherence for chronic conditions, and reduced visits to the emergency department, according to researchers from the University of Michigan (U-M) School of Public Health.

Not unexpectedly, the researchers said it’s too early to tell after two years of study if the Connecticut’s Health Enhancement Program has saved the state money.

A new infographic by U-M describes the key features of the Health Enhancement Program and its impact.

11 Profitable Value-Based Reimbursement Models: Lessons from Early AdoptersCMS’s ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate. Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs). Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare’s per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours’ building of a business case for its multidisciplinary care team to the John C. Lincoln ACO’s deep dive into data analytics to identify and manage the care of high-risk, high-cost ‘VIP’ patients to ‘beat the benchmark’ to WellPoint’s engagement of specialists in care coordination.

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Infographic: The Payor/Provider Perspective on the Switch to Value-Based Care

March 28th, 2016 by Melanie Matthews

Healthcare decision-makers are not ready for the switch to value-based healthcare, according to a new infographic by Xerox.

The infographic highlights results from a recent Xerox study on the payor and provider perspective on value-based healthcare.

Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) has awarded $3 million to 51 specialty medical practices as part of a shared savings arrangement through the company’s Episodes of Care (EOC) program. The doctors, in five different specialty areas, earned the payments by achieving quality, cost efficiency and patient satisfaction goals in 2014 while treating more than 8,000 Horizon BCBSNJ members. As the largest commercial payor of Episodes of Care in the United States, Horizon BCBSNJ recently reported far lower hospital readmission rates and improved clinical outcomes for members in its EOC practices versus non-EOC practices in 2014.

During Episodes of Care: Improving Clinical Outcomes and Reducing Total Cost of Care Through a Collaborative Payor-Provider Relationship, a March 31, 2016 webinar at 1:30 p.m. Eastern, Lili Brillstein, director of the Horizon EOC program, will share the details behind the health plan’s EOC program, from the episodes they have bundled to the goals and results from the program.

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Infographic: Volume to Value Companies Disrupting Healthcare Delivery

December 23rd, 2015 by Melanie Matthews

As the healthcare sector goes through a massive shift to value-based care, digital health is enabling many companies to innovate and deliver solutions to fundamentally change the way individuals receive primary, preventive and personalized care. From mHealth applications to personal diagnostics products, health startup solutions are changing the way care is delivered.

A new infographic by Vigyanix explores some of the companies that are contributing to the future of healthcare.

CMS’s ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate.

Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs).

Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare’s per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours’ building of a business case for its multidisciplinary care team to the John C. Lincoln ACO’s deep dive into data analytics to identify and manage the care of high-risk, high-cost ‘VIP’ patients to ‘beat the benchmark’ to WellPoint’s engagement of specialists in care coordination.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: Value-Based Care Transformation

November 2nd, 2015 by Melanie Matthews

Value-based care and payment reform are prompting hospitals and healthcare providers to more closely manage population health. Hospitals and health systems rely on technology and data to outline the characteristics of their population and identify high-risk patients to manage chronic diseases and deliver enhanced preventative care.

A new infographic by Perficient outlines the key to transforming data in a value-based system.

Value-Based Care Transformation

Healthcare’s inevitable shift from volume to value-based reimbursement is reflected not only in Medicare’s alternative payment timeline but also in the waves of commercial payors now evaluating and rewarding providers on the basis of quality of care delivered rather than number of services provided. Adding to its roster of quality-centered payment models, CMS announced in 2015 plans to explore value-based reimbursement for Medicare Advantage and home health.

2015 Healthcare Benchmarks: Value-Based Reimbursement captures the healthcare industry’s reaction to payment formulas for value-added care, and how this shift away from fee-for-service is transforming care delivery and quality.

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Infographic: Value-Based Payment Readiness

June 17th, 2015 by Melanie Matthews

More than 50 percent of healthcare financial executives have seen positive return on investment (ROI) from value-based payment models, according to a survey conducted by the Healthcare Financial Management Association (HFMA) and sponsored by Humana Inc.

The survey results are depicted in a new infographic released by the organizations. The infographic examines one of the key enablers of positive value-based reimbursement ROI, gaps in interoperability and the need for change in the industry.

Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and MethodologyIf one trend has transformed the healthcare industry post-ACA more than any other, it is the market’s new business model rewarding value over volume.

Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and Methodology provides a framework for healthcare’s new value proposition, with advice from thought leaders steeped in the delivery and reimbursement of value-based care.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

5 Market Trends Affecting Value-Based Reimbursement

March 25th, 2014 by Patricia Donovan

physician compensation

A new economy is reshaping healthcare delivery, measurement and funding.

Changes in the way healthcare is delivered, evaluated and funded are having a serious impact as the industry gradually shifts from productivity- to population-focused compensation, according to Cynthia Kilroy, senior vice president of provider strategy and business development at Optum.

We are seeing five trends in the healthcare industry that are affecting value-based reimbursement, with implications for each.

First, there is a consolidation of the provider community: physicians are organizing, and hospital systems or large integrated delivery networks (IDNs) are actually purchasing physicians. We’re seeing both affiliated and employed models going on in the market right now.

Another influential trend is system affordability. We’ve talked about this a lot, but premiums have been increasing significantly— more than 30 percent over the last five years. A lot of the challenges and what CMS and some payors are trying to focus on is, how can we make healthcare more affordable to the community at large?

A third area of trends is the value-based care models, or the alignment of economic and practice incentives to create accountability. This does not just relate to volume, but also to how to manage populations. Which leads into the next trend, which is the investment of provider organizations in capabilities and tools to manage populations. The result is that the incentive models are moving more toward that population-based care, which is much more challenging to measure.

And then finally, we have a lot of interest in performance metrics—HCAHPS,® for example. With just about every other payor asking for different performance metrics from organizations, how do we really focus, especially from an incentive program for physicians, into the right incentive? More than likely, each organization is going to be different about what they’re trying to achieve; each market is very different.

Excerpted from: 6 Value-Based Physician Reimbursement Models: Action Plans for Alignment, Analytics and Profitability