Humana Issues New Brief on Value-Based Care for Kidney Disease

HIT Consultant | June 12, 2024

Health insurance provider Humana Inc. announced the release of a groundbreaking Value-Based Care (VBC) Issue Brief focused on nephrology, the medical specialty treating kidney disease. The issue brief report highlights the significant potential of VBC arrangements to improve patient outcomes and reduce healthcare costs for individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD). VBC represents a paradigm shift in healthcare, moving away from fee-for-service models that reward the number of patients seen and procedures performed. Instead, VBC incentivizes healthcare providers based on patient outcomes and the quality of care delivered. This focus on results aligns well with the needs of CKD and ESRD patients, who require ongoing management and preventive measures.

Experts Share Health Equity Advances in Value-Based Care at CMS Conference

AJMC | June 10, 2024

During the CMS Health Equity conference, the “Implementing Health Equity Through Value-Based Care for People in Medicare” session featured a series of expert speakers who detailed cutting-edge developments in postacute care and fee-for-service Medicare. They shared their insights on pioneering strategies and new codes designed to meet health-related social needs, highlighting practical approaches that propelled the programs forward. Cindy Massuda, JD, senior technical advisor, CMS, and Chris Palmer, MPA, shared groundbreaking work on health equity in postacute care. Massuda discussed preliminary results from the Screen Positive for Health-Related Social Needs Indicator and summarized national statistics from the 2023 Health Equity Confidential Feedback Reports for Post-Acute Care.

NQF Study: Improvement on Two Quality Measures Could Save 144,000 Lives

Healthcare Innovation | June 3, 2024

A study from the National Quality Forum (NQF) estimates that approximately 144,000 lives could be saved over 10 years by improving just two key areas of quality: colorectal cancer screening and blood pressure control. The study, published in Health Affairs Scholar, used national data to estimate the impact of improved performance on two specific quality measures widely used in public- and private-sector accountability programs. Value-based care programs rely on quality measures to track performance and reward improvement. While there have been numerous estimates of the costs of measuring the quality of care, to this point, the researchers noted that little information about the offsetting human benefit of such value-based payment models has been available. NQF said its research provides evidence supporting the potential of such programs to save lives and avoid harms to patients.

5 biggest barriers when moving to value-based care

Physicians Practice | June 11, 2024

With the current administration of President Joe Biden, the U.S. Centers for Medicare & Medicaid Services (CMS) continue to make health equity a key aspect of value-based care. Studies are increasingly detailing how the conditions in which people are born, grow, live, work, and age – what are known as the social determinants of health (SDOH) – have an enormous impact on health outcomes, which we saw play out in COVID-19 cases. In particular, research documents that SDOH inequities are not only directly related to, but are one of the main causes of disparities in health outcomes. As a result, health providers are increasingly looking at SDOH as comorbidities and are exploring ways to practically integrate SDOH into their care models and recommendations in an attempt to measurably improve patient outcomes. However, according to The Physicians Foundation’s Survey of America’s Physicians, six out of 10 physicians said they do not have the time needed during appointments to adequately address SDOH with patients.