Serving the Value-Based Care Community | |
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Physicians Practice | November 6, 2024
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Value-based care has been heralded as the future of healthcare for more than a decade, but it has yet to fully arrive.This gap is particularly evident in primary care, which must be on board if the promise of value-based care (VBC) is to be achieved. The Commonwealth Fund, a private U.S. foundation dedicated to improving healthcare, recently issued a report exploring why primary care has been so slow to adopt VBC. According to a 2022 Commonwealth Fund survey, just 46% of primary care physicians (PCPs) reported receiving any value-based payments. Commonwealth Fund researchers found that PCPs weren’t opposed to VBC in principle. In fact, they long to get off the fee-for-service (FFS) treadmill, enabling them to spend more time with patients while providing comprehensive, proactive care. The problem, they say, is that VBC and its payment models are not designed or implemented in such a way that makes it possible for them to participate. | | |
Health care leaders emphasized the need for collaboration, data standardization, and an iterative, patient-centric approach to advance value-based care (VBC) during a panel discussion at the Council for Affordable Quality Healthcare (CAQH) Connect 2024 in Washington, DC. The discussion, titled “Value Based Care: The Next Evolution,” included panelists Todd Couts, MS, deputy director of the business services group at CMS; Michael Westover, MBA, vice president of data partnerships and informatics at Providence St. Joseph Health; and Amal Agarwal, DO, MBA, chief clinical officer at Monogram Health. | |  |
Among the nation’s 453 ACOs, Providence’s Health Connect Partners generated the highest shared savings for Medicare in 2023 with $137 million saved through its senior program. After accounting for shared savings and losses, 132 ACOs collectively generated nearly $695 million in net savings, according to CMS and the National Association of ACOs. In 2023, Medicare recorded its largest savings to date — $5.2 billion total, with $2.1 billion going to Medicare and $3.1 billion distributed as shared savings. In 2022, Health Connect Partners also generated the most savings for Medicare compared to other shared savings ACOs, contributing to about $98 million that year. Besides providing the largest Medicare savings from an ACO for two consecutive years, Renton, Wash.-based Providence also accomplished a 2% decrease in readmissions in 2023. | | |
The healthcare industry is slowly moving away from fee-for-service care models and toward value-based care — but contracting in these arrangements remains especially difficult for behavioral health providers, according to Taft Parsons III, chief psychiatric officer at CVS Health/Aetna. He highlighted this issue during a panel discussion on Tuesday at the Behavioral Health Tech conference in Phoenix. The panel focused on how payers approach value-based care in the behavioral health space. Parsons — who is a psychiatrist by training — noted that his company owns Oak Street Health, a network of value-based primary care centers for adults on Medicare. | | |
The 2025 CMS PFS Rule landed with a bang, and it’s not just the weight of the 3,088 pages. We’re one year closer to 2030, the year that CMS intends to have all Traditional Medicare patients in a relationship with a clinician who is accountable for total cost of care. The push to the finish line is the primary driver behind each of the QPP-related policies in this Rule. For CMS to accomplish its goal within its stated time-frame, accountable care programs must promote equity, expand into rural and underserved areas, and align to reduce administrative burden. A slew of new rules will take effect in just two short months, and those who aren’t familiar with the changes and the reasoning behind them will find themselves fighting to keep afloat as these updates and downstream consequences are felt. | | |
Upcoming Sponsored Webinars | |
VBCExhibitHall offers FREE educational webinars for those who are working in value-based care (VBC), or would like to learn more about VBC! We encourage people to attend the live webinars so as to have the opportunity to participate in the Q&A. However, if you are unable to attend, a link to the recorded webinar is sent to all who sign up. Please register using an accurate email address so that you can receive the link to join and to the recording. | |
Healthcare's (Not-so)Secret Weapon: Combining the Power of Advanced Data Analytics with In-depth Price Transparency | December 3, 2024 | 1 PM EST | The workings and importance of advanced data analytics and price transparency, and how to reap the ultimate benefits by combining them | | |
A Payer’s Pathway to an Integrated Fraud, Waste, and Abuse Program |
December 5, 2024 | 1 PM EST | Actionable insights and tools to strengthen an organization’s defenses against FWA | | |
The Crucial Role of Professional Caregivers Post-COVID: Prioritizing, Retaining, and Growing the Workforce | December 10, 2024 | 1 PM EST | Recognizing and supporting professional caregivers, and the funding models that can help drive investment into sustainable caregiving careers | | |
Post-acute care: The nexus of VBC success |
December 11, 2024 | 12 PM EST | How to identify at-risk patients, capture avoidable hospital readmissions, and build collaborative partnerships by utilizing real-time information sharing with hospitals and ACOs | | |
Essential Risk Adjustment Insights 2025-2026: Keeping Health Plans & Providers Ahead of Regulatory & Compliance Challenges | December 12, 2024 | 2 PM EST | A recommended risk adjustment calendar for both years, best practices for health plans and providers, and changes in OIG audit procedures | | |
Unlocking the Connection Between Patient Experience and Provider Satisfaction to Drive Results That Matter | December 19, 2024 | 1 PM EST | How Lucerna's Satisfaction Insight Solution complements other components of their Leap platform providing feedback from both patients and providers and converts then into actionable insights to drive performance improvements | | |
Check back next week for more webinar announcements! | | |
Clinical Blind Spots: Solving for What’s Around the Corner in Value-Based Care |
Round-table discussion with several leading healthcare experts about the challenges and opportunities that are top of mind for their organizations as they head into 2025 | | |
Check out our Webinar Archive to view past webinars on a variety of value-based care related topics! | | | |
FLAACOs Annual Fall Conference | November 20 - 22 | Orlando, FL | Enjoy dynamic speakers, participate in breakout sessions led by top healthcare visionaries, and network with industry peers & leaders. The FLAACOs Annual Conference is the premier professional development and networking opportunity for not only existing and developing ACOs, but any organizations, in Florida and nationwide, that are interested in value-based healthcare models. |
Virtual Third National Primary Care Transformation Summit | December 3 - 6, 2024 | Virtual | Thanks to the generous support of the Patient-Centered Outcomes Research Institute (PCORI) and the Heritage Group, the Summit now offers complimentary registration to full-time practicing physicians, nurses and allied health professionals. |
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ReferralPoint is a referral management solution for health systems, medical groups, and payers to transform their patient referral processes and support their fee-for-service and value-based care populations. Built on a top-performing population health platform, ReferralPoint uses cost and quality data to inform referral decisions to the highest quality, lowest cost, in-network providers then automates insurance verification, prior authorization, scheduling, and closing the loop. Seamless integration allows partners to increase revenue and savings, reduce leakage and costs, improve efficiency, and enhance patient satisfaction, all from within their EHR workflow. |
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Platinum Level Exhibitors
Thank you to our Platinum Level exhibitors! These organizations offer the absolute highest quality products & services to the value-based care community. To learn more & visit their interactive booths, click on the logos below:
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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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Find out how your organization can be featured here and receive additional benefits including a customized booth on our website, social media campaigns, hosted and marketed webinars, an interactive session with top-level VBC executives and consultants, and more! Click here! | | | | |
