Most providers, payers and payviders believe their value-based care (VBC) programs to date have been somewhat, not very, successful, a recent survey has found. Alongside industrywide trends, the Terry Health survey sought to identify areas in which the VBC experience of providers, payers and hybrids aligned or were at odds. It reached more than 400 providers, payers and payviders in the spring of 2023. Terry Health is a part of the Terry Group, a health and actuarial consulting firm.

Given Artificial Intelligence’s potential to improve patient care and reduce costs, it’s no surprise that AI applications are gaining momentum in health care. As your organization explores the benefits of AI in your journey towards Value-Based Care, however, you need to carefully assess the implications, for better and worse. Evaluating AI implications can be tricky. Healthcare AI varies widely, with clinical technology paving the way for advancements in diagnostics and treatment. But pressure on ACOs to achieve savings is spurring consideration of machine assistants for customary clinician services.

Building a Palliative Care-Focused ACO

Hospice News | September 22, 2023

Accountable Care Organizations (ACO) represent a growing opportunity for palliative care companies, and providers have a number of ways to get in on the ground floor. Along with Medicare Advantage, ACOs are one of the few avenues towards more robust reimbursement than fee-for-service models. Operators can come to ACOs by two main avenues. For one, they can become members of those organizations themselves, or they can contract with them through a preferred provider network. This may be increasingly important to explore as the U.S. Centers for Medicare & Medicaid Services (CMS) has announced plans to ensure that 100% of Medicare beneficiaries become aligned with an accountable care entity.

The Covid-19 public health emergency (PHE) prompted an industry-wide shift in healthcare delivery. Most notably, virtual care technologies that were slowly gaining traction pre-pandemic skyrocketed, and now, most healthcare provider organizations offer some form of virtual care. But, with the withdrawal of the PHE declaration in May, the urgent need for deploying telehealth-enabled care services has declined. Thus, healthcare providers are focused on the next step in the evolution of their virtual care strategy. This involves a growing focus on interoperability as virtual care becomes more complex.

Summit Re is a managing general underwriter and reinsurance advisor working with health insurers, managed care organizations, ACOs, and self-funded employers throughout the US. Summit Re promises a consistent, fair, and effective underwriting methodology that factors in the unique characteristics and experiences of their customers and their businesses in order to produce the best long-term results.

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