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  • Bundled Payment Update eNewsletter
  • MACRA MIPS/APM Update eNewsletter
  • Pay for Performance Update eNewsletter

From March 26, 2020
Bundled Payment Update eNewsletter #133

Third of Execs Don't Think Value-Based Payment Will Usurp FFS
Value-based payment adoption has steadily increased, but a third of healthcare executives in a new survey do not believe the alternative payment mechanism will usurp fee-for-service. Fee-for-service mindset and model are too entrenched for value-based payment to take off in the near future., the C-suite executives from hospitals, health systems, and physician groups said in the survey conducted by Sage Growth Partners for DataGen. Other reasons why value-based payment is unlikely to replace fee-for-service included:

  • Clinical staff resistance to value-based payment
  • Low incentives
  • Lack of resources and knowledge to assume risk
  • Volatility of the healthcare industry, especially in the face of change

Aligning businesses with value-based payment will require a hefty lift from provider organizations. These organizations must not only have the budget -- which was the number one reason why some providers are not investing in value-based payment -- but also the right culture, vendor partners, staff, and leadership, the survey of over 100 executives found. Additionally, many healthcare organizations are not seeing the financial benefit of participating in value-based payment models. The majority of respondents said quality is improving under the models, but only 45 percent said financials had improved moderately or significantly. (RevCycle Intelligence, March 11, 2020)

From April 30, 2020
MACRA MIPS/APM Update eNewsletter #52

The Challenges and Opportunities for Hospitals and Health Systems in Moving to Value-based Care

Lori Morgan, MBA
President and Chief Executive Officer, Huntington Hospital; President, Legacy Emanuel Medical Center, Pasadena, CA

From April 16, 2020
Pay for Performance Update eNewsletter #134

Measuring the Value of Care Management: Five Tools to Show Impact

When care management programs fail, it's rarely because they're ineffective. Most likely, it's because health systems don't have an accurate way to measure care management's success and, therefore, don't fully understand (or communicate) its impact on outcomes improvement or cost savings. For care management programs to be successful and demonstrate their value around critical metrics, such as readmissions, health systems need effective technologies and tools that leverage data to give leaders visibility into care management's processes (e.g., how it identifies high-risk and rising-risk patients and assigns them appropriately to care managers) and overall impact. This article explains the challenges health systems encounter when it comes to demonstrating and understanding the measurable value of their care management programs, and how analytics-driven applications can help prove care management's positive impact on outcomes.

This article concludes with the summary Power Point found below.

(HealthCatalyst, April 12, 2020)

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