Value-based Care

How Provider Relationships Shape VBC Pediatric Quality Measures

by Kelsey Waddill

If value-based care in pediatric healthcare truly is the future of value-based care, payers need to leverage strong provider relationships to establish effective pediatric quality measures in order to...

Members Won’t Back Healthcare Price Transparency If Costs Go Up

by Samantha McGrail

Three in four adults would not support a federal regulation that improved healthcare price transparency if the rule raised the cost of health insurance premiums, according to a new Morning Consult...

Humana Foundation Allots $7.6M to Social Determinants of Health

by Samantha McGrail

The Humana Foundation announced it is investing $7.6 million in eight communities across the southeastern United States to address social determinants of health (SDOH), according to a recent press...

BCBS NC, Quartet Partner to Implement Value-Based Payment Model

by Samantha McGrail

Blue Cross and Blue Shield of North Carolina and New York City startup Quartet have announced a partnership to implement a new value-based payment model for mental healthcare.   The...

Medicare Advantage Costs 40% Less than Fee-For-Service Medicare

by Kelsey Waddill

Medicare Advantage has a significant cost reduction value over traditional, fee-for-service Medicare, a recent report from UnitedHealth Group (UHG) found. “Medicare Advantage (MA) plans cover...

AL Providers, Payer Form Value-Based Medicare Advantage Plan

by Kelsey Waddill

Huntsville Hospital and University of Alabama Birmingham Health System (UAB) are partnering to create a value-based Medicare Advantage plan through Viva Health. “We are true partners in our...

How Medicare Advantage Is Leading Payers to Adopt Value-Based Care

by Kelsey Waddill

As America strives for positive changes to the healthcare system, it may find the greatest advancements for value-based care in Medicare Advantage plans. Over 90 percent of healthcare payers in a small Health Care Payment...

High-Deductible Health Plans Spur Maternity Out-of-Pocket Spending

by Kelsey Waddill

The rise in high-deductible health plans due to the ACA’s lack of cost-sharing restrictions in some areas may be leading to high maternity out-of-pocket spending, researchers have...

Data Sharing, Teamwork Essential to Pediatric Value-Based Care

by Kelsey Waddill

Cooperation with providers and data sharing are key to success in pediatric value-based care, Horizon Blue Cross Blue Shield New Jersey (BCBSNJ)’s 2018 care quality results show. “Horizon...

VC-Funded Payer Bright Health Secures $635M in Series D Round

by Kelsey Waddill

Bright Health Plan today announced that it has secured $635 million in Series D funding from the NEA, as VC-funded payers look to 2020. The funding was an oversubscription, exceeding the amount of...

BCBS MI, Provider Orgs Sign Risk-Sharing, Value-Based Contracts

by Kelsey Waddill

Blue Cross Blue Shield Michigan (Blue Cross) is initiating value-based contracts with seven major Michigan healthcare providers under their alternative payment model called the “Blueprint for...

Value-Based Reimbursements Hit 53% in 2017, Reform Slows

by Kelsey Waddill

Update 1/7/2020: This article was updated to reflect that half of the reimbursements in the commercial sector made in 2017 were value-based. Previously, the first line of the article stated that half...

Why the Future of Value-Based Care Begins with Children’s Health

by Emily Sokol, MPH

The healthcare industry is continuing to shift its focus from volume to value. Various value-based care models focus on delivering the highest quality care to patients for the lowest...

Value-Based Care Models Gain Steam, Cut 20% of MA Spending

by Kelsey Waddill

Evidence is mounting to confirm that value-based care models are more cost-effective than fee-for-service, according to Humana’s fifth Value-Based Care Report, which said bundled payments and...

Accessible Data, In-Person Dialogue Key to Value-Based Partnerships

by Kelsey Waddill

There are two elements of value-based care that should come as no surprise to a seasoned healthcare professional regarding value-based partnerships. First, that payer-provider relationships are at the...

UPMC Value-Based Drug Contract Hinges On Disability Progression

by Kelsey Waddill

UPMC Health Plan has entered into a value-based agreement with pharmaceutical manufacturer Biogen to be reimbursed for multiple sclerosis medications on the basis of disability...

Eliminating Waste, Promoting Value Across the Health System

by Emily Sokol, MPH

Healthcare spending accounts for 18 percent of the entire United States GDP. While nearly one-quarter of this spending is unnecessary and wasteful, removing waste from the healthcare system is a...

Strategies to Improve Payer-Provider Relationship, Data Quality

by Emily Sokol, MPH

The 4th Annual Value-Based Care Summit brought payers and providers together from across the country together to discuss best practices in value-based care. Open and frank discussions provided valuable...

CMS Considers AI and Value-Based Care Fraud Prevention Strategies

by Kelsey Waddill

CMS sent out two requests for information, one on program integrity issues regarding the fee-for-service to value-based care transition and the other on how to evolve data analytics and artificial...

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