As they gain experience with alternative payment models, how can healthcare executives do a better job of partnering with community-based organizations (CBOs) to address patients’ health-related social needs and decide what is meaningful to measure? A panel of innovators at the Health Care Payer Learning & Action Network (LAN) Summit in Washington, D.C., described their experiences. The panel was moderated by Marshall Chin, M.D., M.P.H., professor of healthcare ethics at the University of Chicago and the LAN’s Health Equity Advisory Team (HEAT) Co-Chair, and Karen Dale, R.N., M.S.N., market president of AmeriHealth Caritas District of Columbia and HEAT Co-Chair.

Value-based care is often discussed in the context of oncology, where care does not come cheap and its associated toxicities—both financial and clinical—can have a substantial impact on patient quality of life. But efficient collaboration among primary care providers, oncologists, and other care team members is crucial to ensure patients with cancer receive the best possible treatment for their specific disease. Expert presenters and panelists at The American Journal of Managed Care’s Institute for Value-Based Medicine session on September 14, 2023, held in partnership with Zangmeister Cancer Center in Columbus, Ohio, discussed value-based care in the context of primary care and oncology as well as the ways in which providers and practices can work together to improve care for patients with cancer while mitigating financial toxicity.

Information blocking could affect provider payment, MIPS and MSSP participation

Healthcare Finance | October 30, 2023

Providers face monetary disincentives for violating information blocking, under a proposed rule released today by the Department of Health and Human Services. The proposed rule, with 60-day comment period, would establish disincentives for healthcare providers found by the HHS Office of Inspector General (OIG) to have committed information blocking. This is when a provider knowingly and unreasonably interferes with the access, exchange, or use of electronic health information, except as required by law or covered by a regulatory exception. Today's proposal complements former OIG actions establishing information blocking penalties for the other actors such as health information technology (IT) developers of certified health IT or other entities offering certified health IT, health information exchanges and health information networks. It gives teeth to infractions by hospitals, physicians and accountable care organizations.

Recent data indicate that the US is still lagging behind peer countries on maternal health and well-being, with comparatively worsened maternal mortality, preterm birth, chronic disease burden, and unaffordable health care costs among birthing people. Related inequities in severe maternal morbidity, preterm birth, neonatal intensive care unit (NICU) admission, and postpartum readmission only tell part of the story. One in four publicly insured women and one in three Black women report frank mistreatment during childbirth in studies run by the Centers for Disease Control and Prevention as well as independently.

DataLink provides flexible data-driven solutions that help value-based care providers, payers, and organizations improve quality performance, optimize risk accuracy, and reduce costs. With intelligent insights, automated workflows, and advanced interoperability technology, DataLink simplifies value-based care so that providers can focus on what matters most: delivering the best health outcomes. Data-Link is widely recognized for setting industry standards with best-in-class, scalable data-driven solutions that simplify value-based care. 

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