Value-Based Care News

Payer, Provider Value-Based Care Contract Targets Equity, Population Health

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Independence Blue Cross (Independence) has announced that it will renew its long-term value-based care contract with Jefferson Health. The provider will participate in Independence’s Total Value...

Top 3 Major Trends in National Health Outcomes Measures

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Overall, major health outcomes measures are trending in a negative direction, according to America’s Health Rankings Annual Report for 2022. The Annual Report examines 23 measures to assess...

GA Payer Helps Providers Improve Access to Care for Disabled Individuals

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Peach State Health Plan has partnered with the National Council on Independent Living (NCIL) to help improve access to care for patients with disabilities. Although healthcare facilities are designed...

2022 RI Life Index Finds Social Determinants of Health Barriers in RI

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Blue Cross Blue Shield of Rhode Island (BCBSRI) released its 2022 RI Life Index for the fourth year in a row in order to assess social determinants of health barriers and the impact on residents’...

Major Payers Spent Less Than 1% of 2021 Income on Social Determinants of Health

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The share of their income that major payers spend on social determinants of health may have increased over time, but it remains a lackluster percentage, a study published in the Journal of General...

Offering Easy Access to Care Is Key to Positive Member Experience, Retention

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Member experience is key to member retention and, in order to boost member experience, payers must consider whether they are offering easy access to care and straightforward care navigation, according...

Home Health Value Based Purchasing Model Slightly Improved Spending, Care

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Home health value-based purchasing was associated with lower utilization and spending and slight improvements in quality of care, an analysis published in the JAMA Health Forum found. The researchers...

Out-of-Pocket Healthcare Spending for Generics Rose from 2011-2019

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While negotiated drug prices dropped, out-of-pocket healthcare spending on generic prescription drugs increased for patients as generics moved from Tier 1 to tiers typically dedicated to brand drugs,...

States Plan Medicaid 1115 Demonstration Waivers for Incarcerated People

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States across the country are working with the US Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to obtain Section 1115 demonstration waivers to...

Partnership Aims to Improve Health Equity with Clinical Intervention

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In order to address various clinical health disparities, Humana partnered with a healthcare consulting firm and one of Humana’s primary care provider networks to introduce health equity...

Medicare Advantage Boasts Fewer Low-Value Care Services Than FFS Medicare

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Low-value care services were less common for Medicare Advantage (MA) beneficiaries—particularly those in health maintenance organizations (HMOs)—than for traditional Medicare (TM)...

Concerns about Cost of Healthcare Supersede COVID-19 Concerns in MA

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The cost of healthcare is more concerning than the risks of the coronavirus pandemic for Massachusetts residents, according to a poll commissioned by Blue Cross Blue Shield of Massachusetts (Blue...

Emergency Department Patients Are More Likely to Have Chronic Diseases

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Chronic diseases are common among emergency department patients, particularly among seniors and those ages 45 to 64, according to a National Health Statistics Report. “Monitoring ED visits made...

Top 3 Social Determinants of Health Barriers Among Seniors

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Three major social determinants of health factors are particularly predominant barriers to care for America’s seniors: economic instability, loneliness, and food insecurity, according to a study...

7 Ways That Payers Help Members Manage Their Mental Health Needs

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As the nation continues to experience a mental health crisis, health insurers have developed numerous strategies to help members manage their mental health needs, according to a resource from...

3 Major Payers Take Action on Social Determinants of Health

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Updated 9/20/22: A previous version of this article included Blue Cross Blue Shield companies as Elevance Health plans. However, these companies are not Elevance Health companies. This has been...

Healthcare Often Forces Patients to Make Financial Sacrifices

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Many American adults make personal financial sacrifices and miss appointments to cope with the high costs of healthcare, according to a West Health-Gallup Poll.. Due to high and consistent costs,...

Hepatitis C Treatment Rates Reveal Care Disparities in Public, Private Coverage

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Treatment initiation rates for hepatitis C indicate care disparities for individuals who are not White as well as those who are younger and male individuals, a report from the Centers for Disease...

NCQA Adds New HEDIS Quality Measures to Improve Race, Gender Health Equity

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The National Committee for Quality Assurance (NCQA) announced changes to its quality measures for the 2023 Healthcare Effectiveness Data and Information Set (HEDIS), including race and ethnicity data...

How Family Income Impacts Out-of-Pocket, Catastrophic Spending on Insulin

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Family income is a significant factor in the levels of out-of-pocket and catastrophic spending on insulin among insulin users, a study published in Health Affairs found. The researchers leveraged 2017...