Value-Based Care News

7 Out of 10 Americans Struggling With Medical Debt Owe Over $1,000

February 15, 2024 - One in twelve adult Americans owe medical debt, largely those who are uninsured, low-income, or disabled, according to a report from the Peterson-KFF Health System Tracker. Research on rampant medical debt is plentiful, but this study focused on identifying the debtors. Who are the 20 million Americans who owe a total of $220 billion or more in...


Articles

Medicare ACO Enrollment Did Not Improve Mental Healthcare Outcomes

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Medicare beneficiaries newly enrolled in accountable care organizations (ACOs) did not see any improvements in their depression and anxiety symptoms, suggesting Medicare ACOs may need better incentives...

Humana’s Value-Based Care Plans Improved Health Outcomes for MA Members

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Humana Medicare Advantage beneficiaries receiving care under value-based arrangements had better health outcomes, including fewer inpatient admissions and emergency room visits, a report from the payer...

CQMC Revises Quality Measures, AHIP Advocates for Better Alignment

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Core Quality Measures Collaborative (CQMC) released new core quality measures and the implementation guidelines for certain core sets. More than 75 healthcare organizations, including payers,...

Blue Shield of CA Launches Value-Based Pharmacy Model to Lower Drug Costs

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Blue Shield of California (Blue Shield) has launched a value-based pharmacy model to improve member access to affordable prescription drugs. The payer has partnered with five companies to deploy the...

Unnecessary Utilization in CO Leads to $134M in Healthcare Spending

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Updated 8/24/2023: This article has been updated to reflect that the share of healthcare spending on low value care was highest in commercial health plans. Previously, the article framed...

4 Key Inflators That Are Fueling Medical Cost Trends, Pricing

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What drivers influence the medical cost trend, and what steps can payers take to address these factors? The medical cost trend is the percentage that experts anticipate treatment costs will grow...

How Value-Based Purchasing Program Design Influences Outcomes

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Payers should consider program design intensity when implementing value-based purchasing contracts, as higher-intensity programs can lead to better care quality and greater spending reductions, a...

End of COVID-19 Policies Will Influence National Healthcare Spending

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CMS’s Office of the Actuary reported that the average annual growth in national healthcare spending between 2022 and 2031 will exceed the average annual growth in gross domestic product...

6 Ways That Health Plans Can Influence A State’s Health Equity

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With ample fiscal resources and a wide scope of influence, payers can leverage investments, purchasing decisions, network priorities, and other strategies to contribute to health equity, a report from...

CVS Health ACO Partnership Expands Value-Based Care in Long Island

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CVS Health is partnering with Catholic Health to expand value-based care for Medicare beneficiaries through the ACO Realizing Equity, Access, and Community Health (REACH) program. Under the ACO REACH...

How Specialty Pharmacies Compare to Provider, Hospital on Drug Pricing

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AHIP released updated data on drug pricing increases, comparing hospital costs and the prices that physician offices pay compared to specialty pharmacies. The payer organization analyzed price...

Long-Term COVID-19 Symptoms Associated with Higher Unmet Needs

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Patients with a post–COVID-19 condition (PCC) faced higher unmet needs due to affordability and access to care barriers, a study published in JAMA Network Open found. Data for this study came...

58% of Payers Use Outcomes-Based Contracts for Prescription Drugs

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More than half of payers used an outcomes-based contract in 2022, with most preferring contracts with both claims-based and clinical outcomes, an Avalere survey found. The online survey was conducted...

4 Changes to OMB Data Regulations That Could Improve Health Equity

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The Office of Management and Budget (OMB) has an opportunity to improve race, ethnicity, language, sexual orientation, and gender identity data collection practices and health equity nationwide by...

CA VBID Program Boosted Primary Care Use, Contained Healthcare Costs

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California’s value-based insurance design (VBID) program was associated with a higher probability of primary care use, a lower probability of inpatient admissions, and no change in total costs...

UnitedHealthcare Provides Funding to Support Workforce Development

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The UnitedHealthcare Community Plan of Georgia will provide Step Up Savannah with a $95,000 grant in support of its efforts to provide underserved communities with training, healthcare screenings, and...

The Cost of Cancer Should Reflect Impacts on Wellbeing, Productivity

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The cost of cancer goes beyond financial expenditures for adolescent and young adult patients, extending into mental health impacts and workplace productivity losses, according to a report...

How Insulin Costs Vary Across Medicare, Medicaid, Private Plans, Uninsurance

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Insulin costs vary based on insurance coverage type and coverage types that lead to high healthcare spending can force patients to ration their insulin supplies, a report from the US Department of...

Status of Women’s Health Across Insurance Types in 2022

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Women’s health varied by health insurance coverage, with uninsured women experiencing some disparities in preventive care and insured women reporting unwelcome surprises about the limits of their...