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Starting the transition from fee-for-service to value-based care is a challenge. Many provider organizations are simultaneously juggling new reimbursement models with old ones and breaking institutional memory to meaningfully move toward changes. One hospital began its journey to value-based care with an organizational assessment.
Managed Healthcare Executive | August 12, 2021

Value-based care is now firmly entrenched in our healthcare system. Payers credit value-based care with lowering costs, improved outcomes, enhanced payer/provider relationships, and improved patient engagement. With the growth of value-based care models, a trend gaining traction is the transition from treatment at a provider’s site to a patient’s home. This shift to home and community-based care, accelerated by the COVID-19 pandemic, shows no signs of abating. Value-based care is well-suited to handle this change. This model by its nature is focused on wellness; members don’t always need facility-based care. Moreover, value-based care factors in both medical and non-medical aspects of an individual.
It was recently calculated the United States spends $3.8 trillion — or 18 percent of the national economy — on healthcare. The current healthcare landscape indicates this spending rate will not slow anytime soon due to the COVID-19 pandemic, an ongoing healthcare crisis. Value-based care models like Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs) have formed to address the alarming growth in healthcare spending and simultaneously improve the quality and coordination of care in the U.S.
Partnering with private consulting firms could prompt hospitals to participate in a greater number of episodes in a federal bundled payments program, according to new research.
The voluntary Bundled Payments for Care Improvement initiative Advanced Model, or BPCI Advanced, compares spending for specific clinical episodes, like congestive heart failure or sepsis, with benchmarks set by the Centers for Medicare & Medicaid Services. Hospitals take on financial risk in the program — if spending is less than the benchmark for a clinical episode, hospitals earn a reward; but if spending is more, hospitals pay a penalty.
Sponsored Webinars

Leveraging AI-Enabled Remote Patient Management for Preventative Care in the Fight Against Diabetes
  • Topic: diabetes prevalence and progression and its economic impact, and using technology (remote patient monitoring) to identify and serve pre-diabetic populations for better outcomes, better care coordination, and lower overall costs.
Sponsored by: Mozzaz
August 25, 2021 | 1 PM EST

Using Your 2020 MSSP Settlement Pt 3: Calculating accurate and fair shared savings contribution by provider with CMS’s 2020 COVID rule changes
  • Topic: calculating shared savings contribution by TIN and NPI, breaking it out into actionable components using root cause analysis, retention of high performers, and feedback loop to low performers.
Sponsored by: Validate Health
August 26, 2021 | 1 PM EST

Post-Acute Analytics – What’s in It for My ACO?
  • Topic: learning about types of post-acute analytics and their uses, building and sustaining SNF networks, preventing readmissions and adverse events, reducing total costs of care, and earning more shared savings.
Sponsored by: PointRight
August 31, 2021 | 1 PM EST

Upcoming Conferences
11th National ACO Summit
September 20-23, 2021 (Virtual)

FLAACOS Fall Conference
November 4-5, 2021 | Orlando, FL

American Physician Groups Annual Conference
December 9-11, 2021 | San Diego, CA

This week's focus: Secure Healthcare Communications and Workflow
Each week we showcase one of our solution providers in a 4-5 minute interview and ask them what they bring to the ACO Community and what sets them apart. Today's guest:
Platinum Level Exhibitors
Thank you to our Platinum Level exhibitors. These organizations offer the absolute highest quality products & services to the ACO & IPA community. To learn more & visit their interactive booths, click on the logos below:
Gold Level Exhibitors
Thank you to our Gold Level exhibitors. To learn more & visit their interactive booths, click on the logos below:
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